A pilonidal cyst, also known as a pilonidal sinus, refers to an unusual pocket in the skin that collects hair and skin debris, and they are usually found in the skin at the crease of the buttocks, near the tailbone.
Pilonidal cysts are found most commonly among young adult males. It is also linked to:
They are usually caused when ingrown hairs or loose hairs puncture the skin. Ingrown hairs can happen due to excessive friction and pressure on the area due to things such as tight clothing, rubbing of wet skin, cycling, or prolonged sitting. When we get an ingrown hair, our body builds a sac around it in an attempt to push the hair out. This sac eventually grows to become a cyst, which then expands over time if left untreated.
A pilonidal cyst may not cause any symptoms and are more often than not benign. However, pilonidal cysts can become infected, and this can result in the skin around the cyst becoming inflamed, swollen and painful. If this occurs, the cyst can be drained through a small cut on the skin, although sometimes surgery may be required if the cyst becomes too large to drain.
Symptoms of pilonidal cysts include:
Pilonidal cysts can never truly go away on their own because the tract (sinus cavity) is already there, and it has potential to get infected again. You may, however, find relief by applying a hot, wet compress to drain the pus and relieve pain.
Having recurrent infections can be uncomfortable, painful, costly to treat, and may even be life-threatening if it leads to abscesses (swollen pockets of infection) and sinus cavities (empty spaces underneath the skin). If infections are left to go on without treatment for a long time, there is also an increased risk of developing a type of skin cancer called squamous cell carcinoma.
A minor in-clinic procedure can help get rid of the pilonidal cyst. This involves the excision of the pilonidal cyst done under local anaesthesia.
The surgeon will make a cut in the skin and remove the cyst, as well as the contents within it. The wound is then stitched up and packed with gauze. Antibiotics may be prescribed afterwards.
If the incision is closed with stitches, it may take about 4 weeks to completely heal.
Before the surgeon performs the procedure, local anaesthesia is administered so that you feel as little pain and are kept as comfortable as possible.
Pilonidal surgery takes about 45 minutes to perform.
You may shower 24 hours after your procedure. Use water and mild soap to clean the area near the cyst to keep it clean and prevent infection.
No, antibiotics do not heal pilonidal cysts. They will need to be opened and drained. Antibiotics can, however, be prescribed after the procedure to prevent any spread of infection.
Pilonidal cysts are not uncommon, especially among young adult men. If you experience similar symptoms, especially near your tailbone, please seek medical treatment. A simple 45-minute procedure may help prevent complications, such a severe infections, from happening.
Pyon, Rachel E., et al. “Chronic Pilonidal Cyst with Malignant Transformation: A Case Report and Literature Review.” National Library of Medicine, PubMed Central, 17 March 2022, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9018021/. Accessed 7 February 2023.
Saleh, Naveed. “Pilonidal Cyst Surgery: Preparation, Recovery, Care.” Verywell Health, 18 October 2022, https://www.verywellhealth.com/treatment-for-pilonidal-cyst-1124172. Accessed 7 February 2023.
Wilson, Debra Rose, et al. “Pilonidal Cyst Home Treatment: Home Remedies, When to See a Doctor.” Healthline, https://www.healthline.com/health/pilonidal-cyst-home-treatment. Accessed 7 February 2023.