pilonidal cyst

What Is A Pilonidal Cyst?

This is, basically, a chronic skin infection that forms at the bottom of the tailbone or the coccyx. It forms at the upper part between the cheeks of the buttocks. Young adults between 20 and 30 years, especially males, are found to be more affected. Around 3 people out of 10000 get affected every year.

Once formed, the cyst can be full of puss and it can also be very painful. Such happenings are technically termed as a pilonidal abscess. People whose jobs involve sitting for a very long time, as the drivers of trucks, have a higher risk of getting one.

How pilonidal cysts look like?

It looks like a pimple, or there can be a lump formation with swelling. Redness is also observed in some cases. Sometimes, fistula or abscess with tenderness is also found in the buttock-cleft. In extreme cases, bleeding and leakage of puss are also observed.

What are the symptoms?

It can include any or all of the followings:

  • Pain and swelling at the bottom of the spine
  • Redness of the skin
  • Drainage of blood and pus with a foul odor
  • Tenderness of the area
  • Fever

Causes of a Pilonidal Cyst

The causes of pilonidal cysts are not exactly known. Over 80,000 soldiers got pilonidal cysts during World War II. Some school of thought believes this to be irritation due to riding bumpy jeeps. Some also think that it is caused by loose hair penetrating the skin when the body reacts with the embedded hair by forming the cyst.

The risk factors

It is observed that the following can make one more prone to pilonidal cysts.

  • Obesity
  • Prolonged sittingcoupled with an inactive lifestyle
  • Excessive body hairs
  • Stiff or coarse body hairs
  • Local trauma
  • Male gender

Management of Pilonidal Cyst

Treatment of this depends on

  • Symptoms
  • Size of the cyst
  • Whether it is a first tome or repetitive

Depending on the degree and nature of the infection, it can be managed using non-surgical and surgical ways.

Non-Surgical treatment

The simplest non-surgical management of Pilonidal Cyst or sinus is keeping the sacral area free from hairs by shaving, and taking antibiotics to keep the infection under control. All the visible embedded hairs are also plucked off. Applying laser hair removal is another option. However, this does not help at an advanced stage.

Surgical procedure

Sometimes the doctors follow incision and drainage procedure for the first pilonidal cyst. However, this is not effective for repetitive cysts. In such cases a full-scale surgery involving cutting, draining and removal of the pilonidal sinus tract is necessary.

The Dos and Don’ts after surgery

One should always follow medical advice. The followings are some basic guidelines.


  • Keep the affected area clean and dry
  • Wear loose-fitting cotton garments and underwear
  • Consume fibers in plenty for an easy bowel movement


  • No bike riding for at least 6 to 8 weeks
  • No swimming until total healing of the wound