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Acne Help (Home) > Common Skin Disorders > Pilonidal Cyst

Pilonidal Cyst: Infections, Causes, Symptoms and Treatment

Develop when a dead hair or hairs are pushed into the skin forming a canal or passage. This sinus then becomes infected as more debris collects in the sinus. The most common place for a pilonidal cyst to develop is in the skin over the tailbone, just over the cleft in the buttocks. Friction and pressure on the area aggravate the condition along with the presence of bacteria. People are not born with this condition but develop it in the late teens, twenties or thirties. Trauma or injury to the are may cause the cyst to become very tender and painful, producing swelling and drainage.

Pilonidal Cyst Causes

Most doctors think that ingrown hairs cause pilonidal cysts. Pilonidal means "nest of hair." It is common to find hair follicles inside the cyst.

Another theory is that pilonidal cysts appear after trauma to the sacrococcygeal region (the region relating to both the sacrum [the lower vertebrae] and coccyx). During World War II, more than 80,000 soldiers developed pilonidal cysts that required a hospital stay. People thought the cysts were due to irritation from riding in bumpy Jeeps. For a while, the condition was actually called "Jeep disease."

Pilonidal Cyst Symptoms

The symptoms experienced by someone with a pilonidal cyst include the following:

• Pain at the bottom of the spine
• Swelling at the bottom of the spine
• Redness at the bottom of the spine
• Draining pus
• Fever

Care

You may need an antibiotic to fight the infection. Your doctor may have to open the cyst to drain the pus, and may need to remove the cyst surgically.

What you should do

• If the cyst is not infected, keep the area clean and dry. Bathe or shower daily and wash the area well with a germ-killing soap. Taking hot tub baths helps prevent infection. Dry the area well with a towel.
• Avoid tight clothing.
• If the cyst is infected and needs to be cut open and drained, your doctor will pack the wound with gauze. This allows the wound to heal from the inside outwards. You should return to the doctor's office in a few days for a follow-up wound check.
• Do not take tub baths or showers until the gauze is removed. You may wash at the sink.
• After the gauze is removed, apply a warm, wet wash cloth to the area or sit in a tub of warm water for 15 to 20 minutes several times a day to relieve the pain. Then clean the wound gently with mild, unscented soap.
• If your doctor prescribes an antibiotic to fight the infection, take all of the medication exactly as directed, even if you are feeling better. If you stop treatment too soon, some bacteria may survive and re-infect you. If you are using a pain reliever, take it exactly as directed.

Call Your Doctor If...

• You have increased pain, swelling, redness, drainage, or bleeding from the area.
• You develop a high temperature.
• You develop muscle aches, dizziness, or a general ill feeling.

Pilonidal Cyst Treatment

Self-Care at Home

Early in an infection of a pilonidal cyst, the redness, swelling, and pain may be minimal. Sitting in a warm tub may decrease the pain and may decrease the chance that the cyst will develop to the point of requiring incision and drainage.

Medical Treatment

Antibiotics do not heal a pilonidal cyst. Doctors have any of a number of procedures available, including the following treatments.

Incision and drainage

The preferred technique for a first pilonidal cyst is incision and drainage of the cyst, removing the hair follicles, and packing the cavity with gauze.

Advantage - Simple procedure done under local anesthesia

Disadvantage - Frequent changing of gauze packing until the cyst heals, sometimes up to 3 weeks

Marsupialization

This procedure involves incision and draining, removal of pus and hair, and sewing of the edges of the fibrous tract to the wound edges to make a pouch.

Advantages - Outpatient surgery under local anesthesia, minimizes the size and depth of the wound without the need to pack gauze in the wound

Disadvantages - Requires about 6 weeks to heal, needs a physician trained in the technique

Another option is incision and drainage with immediate closing of the wound.

Advantages - Wound completely closed immediately following surgery without need for gauze

Disadvantages - High rate of recurrence (It is hard to remove the entire cyst, which might come back. Typically performed in an operating room, it requires a specially trained surgeon.)

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