What are pilonidal cysts? What causes them? When should you see a doctor? How are they diagnosed and treated? Get all the answers in this comprehensive guide.

Understanding Pilonidal Cysts

A pilonidal cyst is a type of cyst that develops at the bottom of the tailbone, or coccyx. It can become infected and filled with pus, leading to a painful condition known as a “pilonidal abscess.” Pilonidal cysts are more common in men than women and are often seen in younger individuals.

Causes of Pilonidal Cysts

The exact cause of pilonidal cysts is not fully understood, but there are several theories. Most doctors believe that ingrown hairs are a common cause, as hair follicles are often found within the cyst. Another theory is that pilonidal cysts can develop after a trauma to the tailbone region.

During World War II, more than 80,000 soldiers developed pilonidal cysts, which were sometimes referred to as “Jeep disease” due to the belief that the irritation from riding in bumpy Jeeps contributed to their development.

Other risk factors for pilonidal cysts include obesity, excessive hair growth, lack of exercise, prolonged sitting, and excessive sweating.

Symptoms of Pilonidal Cysts

The main symptoms of a pilonidal cyst include:

• Pain, redness, and swelling at the bottom of the spine
• Drainage of pus or blood from the cyst
• Foul odor from the pus
• Tenderness to the touch
• Fever

The size of the cyst can vary greatly, ranging from a small dimple to a large, painful area.

Diagnosing Pilonidal Cysts

To diagnose a pilonidal cyst, your doctor will perform a physical examination and ask you questions about your symptoms, such as when they first started and if you’ve had similar issues in the past. They may also inquire about any medications or supplements you’re taking.

During the early stages of infection, the symptoms may not be severe, so it’s important to call your doctor if you notice any of the signs of a pilonidal cyst.

Treating Pilonidal Cysts

Antibiotics alone cannot heal a pilonidal cyst, but doctors have several treatment options available:

• Incision and Drainage: This is the preferred method for a first pilonidal cyst. The doctor makes a cut into the cyst, drains it, and removes any hair follicles, leaving the wound open and packing it with gauze.
• Marsupialization: In this procedure, the doctor drains the cyst, removes any pus and hair, and then sews the edges of the cut to create a pouch. This allows for a smaller, shallower incision and doesn’t require daily packing of the wound.
• Incision, Drainage, and Wound Closure: In this technique, the cyst is drained, and the wound is fully closed after surgery. This method is less likely to require further treatment, but it also has a higher risk of recurrence.
• Other Surgical Procedures: These include complete cyst and cyst wall excision, the use of fibrin glue, and punch biopsies to remove only the diseased tissue.

Regardless of the treatment method, it’s important to follow your doctor’s instructions for at-home care, such as keeping the area clean and monitoring for signs of infection.

After Surgery

Even after successful treatment, pilonidal cysts may recur. To help prevent this, it’s important to keep the area clean, avoid excessive sweating, and maintain good hygiene habits. Regular follow-up appointments with your doctor will also allow them to monitor the healing process and catch any new issues early.

Key Takeaways

Pilonidal cysts are a type of cyst that can develop at the bottom of the tailbone, leading to a painful, infected condition known as a pilonidal abscess. While the exact cause is not fully understood, ingrown hairs and trauma to the area are believed to be contributing factors.

Symptoms of a pilonidal cyst include pain, redness, swelling, drainage of pus or blood, and a foul odor. Doctors can diagnose the condition through a physical examination and by asking about your symptoms.

Treatment options include incision and drainage, marsupialization, and various surgical procedures. It’s important to follow your doctor’s instructions for at-home care and attend regular follow-up appointments to monitor for any recurrence of the condition.