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Conditions Treated
Anorectal Disorders
Pilonidal Cyst

What are Pilonidal Cyst?

Pilonidal cyst (pilo-nidal = “nest of hair”) is a common condition in which an abnormal small hole or tunnel in the skin is present containing hair and skin debris. It is almost always present in the midline at the top of the cleft between the buttocks.
1. Symptoms of Pilonidal Cyst
Most patients with Pilonidal cysts do not have symptoms. The symptoms appear when the cyst becomes infected. The most common symptoms include:
  • Swelling.
  • Pain.
  • Redness or changes in color.
  • Drainage of pus or blood.
The exact cause of a Pilonidal cyst is not always known. In most cases, the area where hair grows out of the skin gets infected. A skin problem, pressure, or friction may cause hair between the buttocks to be pushed inwards resulting in infection.
Pilonidal cyst is seen commonly in:
  • Young adults (pilonidal cysts are most common in people in their 20s).
  • Men (more affected than women).
  • Persons with a lot of body hair.
  • Obese persons.
  • Persons spending a lot of time sitting down.
  • Those with skin injuries.
  • Patients with skin irritation.
  • Complications of Pilonidal Cyst
  • Sepsis.
  • Severe pain.
  • Infection spreading to nearby areas.
  • Fistula formation.
Your doctor will make a diagnosis of Pilonidal cyst by taking a detailed history and looking at the affected area. Your doctor may recommend routine blood tests and send the drained pus for cultures.
If Pilonidal cyst is not infected and is not causing symptoms, treatment is often not needed. Your doctor may recommend a “watch and wait” approach. It is very important to keep the area between your buttocks clean by bathing regularly. Your doctor may advise you to shave the affected area to make it clean and reduce the risk of infection.
If Pilonidal cyst is infected, further treatment of the infection depends on your symptoms, the size of the cyst, amount of pus draining, and whether it is your first cyst or a recurring problem. A Pilonidal cyst abscess often needs to be drained and treated with antibiotics and pain killers. For a recurring Pilonidal cyst, a number of treatment options are available. Your doctor will discuss these options with you.
  • Wide excision and open healing: for large and recurring Pilonidal cyst abscesses, the cyst is surgically removed with some surrounding skin and the wound is left open to heal naturally.
  • Incision and drainage: for uncomplicated Pilonidal cyst abscess, your doctor may advise an outpatient incision and drainage under local anesthesia. During this procedure, a small hole is made in the abscess so the pus can be drained.
Physical activity is encouraged as can be tolerated. You should not lift heavy objects nor do strenuous exercise until the wound is healed. No specific dietary restrictions are needed.
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