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      What is Pilonidal cyst? Causes, Treatment & Symptoms

      Common Health Problems

      What is Pilonidal cyst? Causes, Treatment & Symptoms

      Updated on 3 November 2023

      A pilonidal cyst is a skin abnormality that typically comprises hair and skin debris. A hair pilonidal cyst is nearly always seen at the tailbone, towards the apex of the buttock cleft.

      What is a pilonidal cyst?

      Pilonidal Cysts form when hair penetrates the skin and gets lodged. When a pilonidal cyst becomes infected, the abscess's pilonidal cyst pain level is frequently exceedingly high. The hair pilonidal cyst can be surgically removed or drained by a tiny incision.

      Pilonidal cysts are most frequent in young males, and the condition is prone to recurring. People who sit for extended periods, such as truck drivers, are more likely to acquire a Pilonidal Cyst.

      Causes of pilonidal cyst

      The specific cause of pilonidal cysts is unknown. The majority of pilonidal cysts, however, appear to be generated by loose hairs that enter the epidermis.

      It was once considered that pilonidal cysts were congenital (born with them). They formed either from embryologic cells in the incorrect place early in development or from repeated trauma (jeep driver's illness). Small clumps of hairs and debris (dead skin cells and bacteria) stick in the skin's pores in the upper cleft of the buttock and create a "sinus," or pocket, known as a Pilonidal Sinus Cyst, which expands to become an abscess. This abscess grows beneath the skin (subcutaneously) and can leave scar tissue that can become infected again and again.

      Friction and pressure, such as skin rubbing against skin, tight clothes, biking, lengthy periods of sitting, or similar circumstances – push the hair down into the skin. The body forms a cyst near the hair in response to being seen as a foreign material.

      Some infants are born with a sacral dimple, a depression immediately above the buttock crease. A pilonidal cyst might form if the sacral dimple becomes inflamed.

      Symptoms of pilonidal cyst

      There may be no symptoms if a pilonidal cyst is not infected. Signs and symptoms of an infected cyst include:

      • Fever

      • Discomfort at the top of the buttocks

      • Pain in the lower back

      • Swelling

      • Redness

      • Blood or pus discharge from a pilonidal cyst pop

      • Awful smell

      Treatments for pilonidal cyst

      Doctors will provide an individualized treatment plan if you are diagnosed with one or more pilonidal cysts.

      Depending on the seriousness of your symptoms, surgical pilonidal cyst removal may or may not be necessary. There are various alternative options for pilonidal cyst treatments to surgery, including:

      • To drain the cyst: Doctors can perform this operation in their clinics. The diseased cyst will be opened and drained using a minor incision (cut).

      • Injections: Injections (phenol, an acidic chemical component) can cure and prevent pilonidal cysts that are mild to moderate.

      • Antibiotics: Pilonidal cyst antibiotics can cure inflammation of the skin. However, antibiotics alone cannot cure pilonidal cysts.

      • Laser treatment: A laser treatment helps eliminate hair that would otherwise develop ingrown and induce the recurrence of pilonidal cysts.

      While waiting for your treatment, the patients can try relieving themselves of any discomfort with a warm compress applied to the affected area or can use an inflatable seat or mattress.

      Pilonidal cyst surgery

      Suppose substantial scar tissue or a chronic sinus tract is discovered in the pilonidal cyst. In that case, a patient may require excision or a pilonidal cyst surgery to remove the abscess. A Pilonidal Cystectomy aids in the pilonidal cyst removal along with sinus tracts. The wound can be packed with gauze or sutured shut. A cleft lift/modified Karydakis treatment removes damaged skin, not deeper tissue, and the incision is moved to the side for better healing.

      Other forms of pilonidal cyst surgery include flap treatments that remove more significant quantities of tissue, such as the Limberg flap, Z-plasty, and rotating flap.

      Suppose a patient has a severe infection (cellulitis or sepsis) or is suffering from an immunocompromised (HIV/AIDS, cancer chemotherapy, steroid treatment, or other immune-modulating medicines) condition. In that case, the patient may have a typical recommendation for pilonidal cyst antibiotics treatment and may require hospitalization.

      Metronidazole is one of the most often recommended antibiotics for pilonidal cyst infections. It may aid in the healing of an abscess by preventing germs from growing. The patient can take metronidazole orally or through intravenous administration before surgery.

      Recovery from pilonidal cyst surgery

      The recovery period for pilonidal cyst surgery varies depending on whether the incision is open or closed. An open incision can take up to eight weeks to heal into a patch of scar tissue (tissue is eliminated, leaving a hollow, and the body heals from the inside out). Recovery is much faster if the incision is closed (sutured by the doctor), but there is a more significant danger of reinfection, which might prolong healing. The cleft lift/modified Karydakis treatment has a four-week recovery period. In general, inflammation can persist for up to six days, while new tissue development can last up to two months.

      Pilonidal cyst treatments of nonsurgical nature are helpful only when the cyst is tiny, and the symptoms are modest and infrequent. Use proper cleanliness, exfoliate the region, sit with good posture, and use a coccyx cushion to keep the cyst from worsening.


      The prognosis for a pilonidal cyst is typically favorable, and the cyst is commonly curable with surgery. Unfortunately, recurrent abscesses are common if scar tissue or sinus development develops.


      1. Nixon, A.T., Garza, R.F. (2022). Pilonidal Cyst And Sinus.
      2. da Silva JH. (2000). Pilonidal cyst: cause and treatment.
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      Written by

      Madhavi Gupta

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