All About Pilonidal Cysts: Symptoms, Causes, Prevention and Treatment

You may have a pilonidal cyst and not even know it. But, if the spot ever becomes infected, you're sure to feel it. Fortunately, with a doctor's help, you can treat this condition and get back to sitting in comfort.

If your rear has suddenly gotten quite painful or you have noticed a small pit at the top of your buttocks, it's time for you to learn about pilonidal abscesses and cysts. I've put together this informational page all about pilonidal cysts to help you learn about this condition and its symptoms, causes, prevention methods and treatments.

What Is a Pilonidal Cyst?

Pilonidal cysts are medical conditions that develop near the end of the tailbone. They occur near the top of where the buttocks meet, which is known as the cleft of the buttocks. They can also be located within the cleft.

The cyst is a small hole or depression in the skin. Sometimes, it just looks like a little dimple on the lower back.

However, a cyst can become infected and filled with pus. When this happens, it is known as a pilonidal abscess.

Having a pilonidal cyst can also be known as having pilonidal disease. Another term that is associated with this condition is pilonidal sinus. That is because a sinus is a tunnel in the body, and in pilonidal disease, there is a small tunnel that runs between the bottom of the hole and the outer layer of skin.

If you look at a pilonidal cyst, you may see a small pit in the skin. You may notice hair coming out of it or see dark spots within the hole.

What Causes a Pilonidal Cyst?

Doctors do not fully agree on what causes pilonidal cysts, but it seems to be related the hair in the area.

Many doctors think that ingrown hairs near the cleft of the buttocks are the cause. Hairs that grow downward into the skin can irritate the area and lead to an infection.

Other experts believe that the problem has more to do with hair follicles. They think that a cyst forms when a follicle ruptures.

Even though the exact cause is not definitively known, experts do know that there are some risk factors that can contribute to the development of a pilonidal cyst. These include:

Learn more about symptoms and causes in the video Pilonidal Cyst (Medical Condition).

Related to pilonidal cysts, some babies are born with a sacral dimple. This is a small hole or depression on a person's lower back. A sacral dimple is normally not a concern, but there is a possibility of a this pit becoming an infected pilonidal abscess at some point in life.

Learn more about this condition in the video "Sacral Dimples: First with Kids - Vermont Children's Hospital, Fletcher Allen."

What Are the Symptoms of a Pilonidal Cyst?

Sometimes, a pilonidal cyst is asymptomatic, and it doesn't cause any trouble.

The problem arises when a pilonidal cyst becomes irritated or infected. An abscess forms and symptoms become noticeable.

An abscess can form a lump or bump on the skin. You may be able to see it in the mirror or feel it with your hand. The spot may be tender or swollen, and it may be red. It could be just a small bump or a large swollen area.

Sometimes, blood or pus may leak from the abscess. The leaking fluid may have an unpleasant smell.

An infected cyst can be quite painful. For many people, the pain is most noticeable when they are sitting down.

Having a fever is another potential side effect of a pilonidal cyst, but this is a less common symptom. Nausea and feelings of weakness are other fairly uncommon symptoms.

Although a pilonidal cyst can cause serious pain and irritation if it becomes infected, it is a benign condition. These cysts are not related to cancer, nor do they lead to cancer.

How Can Cysts Be Prevented?

Paying special attention to the skin and hair in this area can help discourage a pilonidal cyst from forming. Using water and a mild soap, wash the skin regularly. Pat the region dry with a towel.

Use a brush with soft bristles to scrub the area. This exfoliation may prevent ingrown hairs from developing. Another way to avoid ingrown hairs is to remove the hair in the area with a depilatory or a razor.

Being active can also help. Sedentary lifestyles and excess weight can contribute to the development of cysts. Regular exercise can keep you active and may also help you shed excess pounds. Even if you have a job that involves a good deal of sitting, try to take regular breaks for movement.

How Are Cysts Treated?

A pilonidal cyst can be diagnosed by a doctor. He or she will observe the affected area and inquire about your symptoms. If you are diagnosed with this condition, your doctor will discuss treatment options with you.

If you have an infected pilonidal cyst, antibiotics alone will not be enough to heal the condition. Instead, you will need to receive pilonidal cyst treatment from your doctor.

Home Treatment

Although home remedies for pilonidal cysts are not recommended, if you are experiencing pain and discomfort, there are things you can do at home to feel better until you are able to see the doctor.

A warm bath can provide relief. After soaking in the tub, pat the skin dry with a towel. When not bathing, keep the area dry.

Over-the-counter pain relievers can help lessen the pain. If you have a fever, a pain reliever may help bring it down.

Draining

A doctor can clean out a cyst. The pus is drained, and any debris in the cavity is removed. After the treatment, the area is packed with gauze until it heals. Draining a cyst is an in-office procedure that requires only local anesthetic.

Even if your cyst is not infected, you may want to talk to your doctor about cleaning out any material that is trapped inside. This can help prevent infection before it develops.

The recovery time for this procedure is about four weeks. The doctor may prescribe antibiotic medication during this time. The gauze packing will need to be changed regularly.

For many people, cleaning and draining the site is sufficient treatment to resolve the problem. Particularly if preventive care, such as shaving the area, keeping it dry and staying active, is practiced, the condition may not recur.

Surgery

Even though draining a cyst can be an effective treatment, some people do have a recurring problem with infected cysts. For these patients, a doctor may recommend pilonidal cyst surgery.

In surgery, instead of simply draining the cyst, the doctor removes it from the body. Both the skin and the underlying tissue in the area are cut away.

After surgery, the doctor may stitch the incision site closed. Another option is to leave it open and pack it with gauze. Sometimes, the doctor will also place a drainage tube at the site.

A stitched or sutured wound will heal more quickly, but leaving it open reduces the likelihood that the area will become reinfected. Therefore, especially for patients who have had long-term struggles with infected cysts, leaving the would open is sometimes the better course of action.

The recovery time varies depending on how the surgical site is closed. It can take just a few weeks or as long as several months to fully heal.

Properly caring for the surgical site can help reduce the chances of reinfection. Your doctor's directions may vary depending on the type of closure you had, but they may involve keeping the area dry, removing hair in the area, changing the dressing or packing regularly and returning for follow-up visits.

A pilonidal cyst that becomes infected can cause pain and irritation. Do you have questions about this condition? Leave a comment below. Remember, if you think you have a pilonidal cyst, here is what you should do: