Formation of an abnormal pocket in the skin, commonly containing skin debris and hair, is known as Pilonidal Cyst or Pilonidal Abscess. It is majority of the times found close to the coccyx (tailbone), the area above the buttocks' cleft. These cysts are formed when the hair pierces through the skin and gets lodged there. Infection in the pilonidal cyst results in abscess, which can be very painful. Young men and people, who sit for long periods of time, such as in front of the computer or driving, are more prone to developing a Pilonidal Cyst or Pilonidal Abscess. These cysts tend to recur in the future even after treatment.

Pilonidal Cyst or Pilonidal Abscess

Treatment comprises of draining the cyst via a small incision or surgically removing the cyst.

Causes of Pilonidal Cyst or Pilonidal Abscess

There are different views on the cause of Pilonidal Cyst or Pilonidal Abscess. Common cause is when some loose hairs puncture the skin and get lodged there. Added friction/ pressure when the skin gets rubbed, wearing tight clothes, cycling, and sitting for prolonged duration of time etc. further push the hair into the skin. The body treats this hair as a foreign substance and forms a cyst around the hair.

Another probable cause is movement or stretching of the deep skin layers leading to increase and rupture of the hair follicle, resulting in formation of a cyst around the ruptured hair follicle.

Risk Factors for Pilonidal Cyst or Pilonidal Abscess

  • Being overweight or obese.
  • Sedentary lifestyle.
  • Coarse or stiff hair.
  • Excessive/surplus hair on the body.
  • Having an occupation where you have to sit for prolonged periods of time.
  • Bad hygiene.

Symptoms of Pilonidal Cyst or Pilonidal Abscess

If there is an infection of the Pilonidal Cyst or Pilonidal Abscess, then an abscess is formed which can cause a lot of pain. Symptoms of infection are:

  • Pain and redness of the skin.
  • Pus or blood draining from an aperture in the skin.
  • Foul smell from the oozing pus.

Treatment for Pilonidal Cyst or Pilonidal Abscess

  • Treatment, if there is an infection of the Pilonidal Cyst or Pilonidal Abscess, comprises of draining the cyst where the doctor will anesthetize the cyst area and perform a small incision to drain the cyst.
  • If there is recurrence of the cyst (which happens often), then surgery is done to remove the entire cyst.
  • After the surgery there are 2 options. One is to leave the wound open and cover it with a dressing so that it heals from the inside out. This procedure takes a long time to heal, but the risk of recurrence of the cyst is low.
  • Another option after the surgery is closing the wound using stitches. This option has shorter healing time, but the risk of recurrence is higher.
  • It is very important to take proper care for the wound after the surgery. You should change the dressings regularly according to your physician's instructions. The region of the surgery also needs to be shaved regularly to avoid the hairs from entering the wound.

Prevention of Pilonidal Cyst or Pilonidal Abscess

  • Always keep the cyst prone area clean.
  • If your job requires prolonged periods of sitting, then take breaks in between and walk around. Avoid prolonged periods of sitting.
  • If you are overweight, then you need to lose the excess weight.
  • Shave the region of the previous pilonidal cysts. This will decrease the risk of recurrence.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: May 6, 2014

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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