Pilonidal Cyst

1 What is Pilonidal Cyst?

A pilonidal cyst, an abnormal pocket in the skin containing hair and skin debris, occurs when hair punctures the skin and becomes embedded.

A pilonidal cyst is usually located at the top of the cleft of the buttocks or near the tailbone and can be infected.

The abscess thus formed is very painful and can be drained by a small incision or surgically removed.

Pilonidal cysts have higher chance of occurrence in people who tend to sit for a longer period of time such as, truck drivers.

It is mostly prevalent in young men with chances of recurrence.

2 Symptoms

The symptoms of pilonidal cyst include:

  • Pain
  • Reddened skin
  • Drainage of pus or blood from an opening in skin
  • Foul smell from draining pus

An infected pilonidal cyst is swollen due to presence of abscess.

When to see a Doctor

Visit your doctor if you experience any signs or symptoms of pilonidal cyst.

3 Causes

The cause of pilonidal cysts has not yet been found.

They are believed to be caused by penetration of loose hairs into the skin. Friction and pressure (due to factors such as, tight clothing, longer sitting time, bicycling and skin rubbing against skin) causes the hair to be forced down into the skin.

The body responds the hair as a foreign substance and develops a cyst around the hair.

This explains the occurrence of pilonidal cysts in other parts of body than near the tailbone.

For example, presence of pilonidal cysts in between the fingers in barbers, dog groomers or sheep shearers.

4 Making a Diagnosis

Your physician will make a diagnosis of pilonidal cyst during physical examination. After examination he may immediately refer you to dermatologist or surgeon for surgery.

What your doctor wants to know?

You may want to be well prepared for the questions that your doctor is likely to ask.

Some of the questions that your doctor most probably asks are:

  • Have you got fever?
  • Does the pain disturb your sleep?
  • What is your occupation?
  • Do you sit all day?
  • When did your symptoms begin?
  • Have you had this condition before?
  • Does anything improve or worsen your symptoms?
  • Any medication or supplements that you take regularly?

5 Treatment

The initial treatment of the pilonidal cysts starts with numbing the area with injection followed by making a small incision to drain the infected cyst.

The cyst is removed entirely by an extensive surgical procedure if it recurs. Wound care after surgery is very important.

Your doctor may opt to leave the wound open after the surgery. In this case, the wound is covered with dressing and allowed to heal.

This requires longer healing time and has lower chances of recurrence. The second option the doctor may choose is to close the wound with stitches.

In this case, the chances of recurrence are high whereas healing time is shortened.

Your doctor or nurse will thoroughly explain you on how to change the dressings, what to expect while healing and when to call a doctor.

You may have to shave around the surgical site to avoid hairs from entering the wound.

6 Prevention

To help prevent pilonidal cysts, try to:

  • keep the area clean.
  • not to sit for prolonged period.
  • lose weight if necessary.
  • Shave the area or use hair removal products, to lessen the chances of recurrence.

7 Risks and Complications

You are more likely at a higher risk of developing pilonidal cysts if:

  • You are male or young (most common in people in their 20s)
  • You are obese or have sedentary lifestyle
  • You are doing jobs that demands prolonged sitting
  • You have excess body hair or stiff or coarse hair

The risk of developing squamous cell carcinoma (a form of skin cancer) is slightly increased if the chronically infected pilonidal cyst is not treated properly.