What is a pilonidal cyst. How does a pilonidal cyst form. What are the symptoms of an infected pilonidal cyst. Who is at risk for developing pilonidal cysts. How are pilonidal cysts diagnosed and treated. What can be done to prevent pilonidal cysts from recurring.

Understanding Pilonidal Cysts: A Comprehensive Overview

A pilonidal cyst is a fluid-filled sac that develops under the skin, typically near the tailbone area or in the crease between the buttocks. These cysts can range from being barely noticeable to causing significant discomfort, especially when infected. To better understand this condition, let’s explore its nature, causes, and impact on those affected.

What exactly is a pilonidal cyst?

A pilonidal cyst is a pocket that forms around hair follicles in the natal cleft, the area between the buttocks. While some cysts may not be visible, others can appear as small pits or dimples in the skin. These cysts are generally harmless unless they become infected, at which point they are referred to as pilonidal abscesses.

How do pilonidal cysts form?

The formation of pilonidal cysts is believed to be caused by a combination of factors. When we sit or bend, the skin in the tailbone area stretches, which can cause hairs to break off. As we move, these broken hairs and dead skin cells can get pushed under the skin. The body’s immune system then treats these foreign particles as a threat, forming a cyst around them that fills with fluid.

Recognizing the Signs and Symptoms of Pilonidal Cysts

While an uninfected pilonidal cyst may not cause any noticeable symptoms, an infected cyst can lead to several uncomfortable and potentially severe symptoms. Being aware of these signs can help in early detection and treatment.

What symptoms indicate an infected pilonidal cyst?

An infected pilonidal cyst, also known as a pilonidal abscess, may present with the following symptoms:

• Pain, redness, and swelling in the area of the cyst
• Pus or blood draining from a small opening (sinus tract) in the skin over or near the cyst
• Fever
• Discomfort when sitting or during movement

If you experience any of these symptoms, it’s crucial to seek medical attention promptly to prevent further complications.

Risk Factors and Predisposition to Pilonidal Cysts

While pilonidal cysts can affect anyone, certain factors may increase the likelihood of developing this condition. Understanding these risk factors can help in taking preventive measures and managing the condition effectively.

Who is more susceptible to developing pilonidal cysts?

Pilonidal cysts are most common in young men, but several factors can increase the risk of developing them:

• Being born with a dimple or pit in the tailbone area
• Spending extended periods in a sitting position
• Being overweight or obese
• Having excessive body hair, especially if it’s thick or coarse
• Wearing tight clothing that puts pressure on the tailbone area
• Having a family history of pilonidal cysts

By being aware of these risk factors, individuals can take steps to minimize their chances of developing pilonidal cysts or manage existing ones more effectively.

Diagnosis and Treatment Options for Pilonidal Cysts

Proper diagnosis and timely treatment of pilonidal cysts are essential for managing symptoms and preventing complications. Let’s explore the diagnostic process and various treatment options available.

How are pilonidal cysts diagnosed?

Doctors typically diagnose pilonidal cysts based on their location, appearance, and physical examination. The characteristic position near the tailbone and the presence of visible pits or sinuses in the skin are often sufficient for diagnosis. In some cases, additional imaging tests may be required to assess the extent of the cyst or to rule out other conditions.

What treatment options are available for pilonidal cysts?

Treatment for pilonidal cysts depends on the severity of the condition and whether the cyst is infected. Here are some common treatment approaches:

1. Conservative management: For asymptomatic cysts, no treatment may be necessary. Regular monitoring and maintaining good hygiene can be sufficient.
2. Home care: Mild infections can be managed with sitz baths and warm compresses to promote drainage and relieve discomfort.
3. Gips procedure: For more severe infections, doctors may perform a minor surgical procedure called the Gips procedure. This involves making a small incision to drain the abscess.
4. Antibiotics: If the infection spreads to the surrounding skin, oral antibiotics may be prescribed.
5. Surgical removal: In cases of recurrent or persistent cysts, surgical removal of the entire cyst may be recommended.

The choice of treatment depends on individual circumstances and should be discussed with a healthcare provider.

Managing Pilonidal Cysts at Home: Tips and Precautions

While medical intervention is often necessary for infected pilonidal cysts, there are several steps you can take at home to manage symptoms and prevent recurrence. Here are some helpful tips for caring for a pilonidal cyst:

How can you care for a pilonidal cyst at home?

• Clean the affected area thoroughly as directed by your healthcare provider
• Remove hair from the area regularly through shaving or using hair removal products, if recommended by your doctor
• Avoid sitting for prolonged periods
• Sleep on your side or stomach to reduce pressure on the affected area
• Maintain a healthy weight to reduce friction in the tailbone area
• Wear loose-fitting clothing to minimize pressure and irritation

If you’ve had a pilonidal cyst drained, follow these additional steps:

• Take prescribed antibiotics as directed
• Change or remove bandages as recommended by your healthcare provider
• Avoid bathing or swimming until your doctor gives you the green light

By following these guidelines, you can promote healing and reduce the risk of complications or recurrence.

Surgical Interventions for Recurrent or Severe Pilonidal Cysts

In some cases, conservative treatments may not be sufficient to manage pilonidal cysts, especially if they are recurrent or severe. Surgical interventions may be necessary to provide long-term relief and prevent future complications.

When is surgery recommended for pilonidal cysts?

Surgery may be considered in the following situations:

• Recurrent infections despite conservative management
• Chronic pain or discomfort
• Multiple sinus tracts or extensive cyst formation
• Inability to perform daily activities due to the cyst

What surgical procedures are available for pilonidal cysts?

Several surgical techniques can be employed to treat pilonidal cysts:

1. Wide excision: This involves removing the entire cyst and surrounding affected tissue, leaving the wound open to heal from the bottom up.
2. Excision with primary closure: The cyst is removed, and the wound is closed with sutures.
3. Minimally invasive techniques: These include endoscopic pilonidal sinus treatment (EPSiT) and pit picking, which aim to remove the cyst with smaller incisions and faster recovery times.
4. Flap procedures: In complex cases, skin flaps may be used to cover the surgical site and promote healing.

The choice of surgical technique depends on the individual case and should be discussed with a surgeon specializing in pilonidal cyst treatment.

Prevention and Long-term Management of Pilonidal Cysts

While pilonidal cysts can be challenging to prevent entirely, there are steps you can take to reduce your risk of developing them or experiencing recurrences. Long-term management is crucial for those who have had pilonidal cysts in the past.

How can you prevent pilonidal cysts from recurring?

To minimize the risk of pilonidal cyst recurrence, consider the following preventive measures:

• Maintain good hygiene in the tailbone area
• Keep the area dry and free from excessive moisture
• Regularly remove hair from the affected area through shaving or other hair removal methods
• Consider permanent hair removal options like laser treatment
• Avoid prolonged sitting and take frequent breaks to stand or walk
• Maintain a healthy weight to reduce pressure and friction in the tailbone area
• Wear loose-fitting clothing that doesn’t put pressure on the tailbone

By incorporating these practices into your daily routine, you can significantly reduce the likelihood of developing pilonidal cysts or experiencing recurrences.

What long-term considerations should be kept in mind?

For individuals who have had pilonidal cysts or are at high risk of developing them, long-term management is essential. This may include:

• Regular follow-up appointments with your healthcare provider
• Ongoing hair removal in the affected area
• Lifestyle modifications to reduce risk factors
• Prompt attention to any signs of recurrence or infection

By staying vigilant and proactive in your approach to pilonidal cyst management, you can minimize the impact of this condition on your quality of life and reduce the need for repeated treatments or surgeries.

Understanding pilonidal cysts, their causes, symptoms, and treatment options is crucial for effective management of this condition. By recognizing the signs early, seeking appropriate medical care, and following preventive measures, individuals can minimize the impact of pilonidal cysts on their daily lives. Remember that each case is unique, and it’s essential to consult with a healthcare professional for personalized advice and treatment plans tailored to your specific situation.

Pilonidal Cyst (for Parents) – Nemours KidsHealth

en español: Quiste pilonidal

Reviewed by: Elana Pearl Ben-Joseph, MD

Primary Care Pediatrics at Nemours Children’s Health

What Is a Pilonidal Cyst?

A pilonidal cyst is a fluid-filled sac under the skin in the lower back, near the crease of the buttocks. Some aren’t visible, while others can look like a small pit or dimple in the skin.

They don’t usually cause problems or need treatment unless they get infected. A pilonidal (pie-luh-NIE-dul) cyst that’s infected is called a pilonidal abscess.

What Are the Signs & Symptoms of a Pilonidal Cyst?

A cyst that isn’t infected might not cause any symptoms. Someone with an infected cyst can have:

• pain, redness, and swelling in the area of the cyst
• pus or blood draining from a small opening (called a sinus tract) in the skin over or near the cyst
• a fever

What Causes a Pilonidal Cyst?

Doctors think that pilonidal cysts form when loose hair and dead skin cells get trapped under the skin. When we sit or bend, skin in the tailbone area stretches. This can cause hairs to break off. As a person moves, the broken hairs and dead skin cells can get pushed under the skin. The immune system treats the hair and dead skin cells as foreign, and forms a cyst around them that fills with fluid.

Who Gets Pilonidal Cysts?

Anyone can get a pilonidal cyst, but they’re most common in young men.

A person can be more likely to develop a pilonidal cyst if they:

• are born with a dimple or pit in their tailbone area
• spend a lot of time in a sitting position
• are overweight
• have a lot of body hair, especially if it’s thick or coarse
• wear tight clothing that presses on the tailbone area
• have family members with a pilonidal cyst

How Is a Pilonidal Cyst Diagnosed?

Doctors usually diagnose a pilonidal cyst based on where it is and how it looks and feels.

How Is a Pilonidal Cyst Treated?

A cyst that doesn’t cause symptoms might not need treatment.

Treatment for a pilonidal abscess depends on how severe the infection is. Home care with sitz baths and warm compresses can treat mild infections. If home care doesn’t work or the infection is more serious, doctors might make do the Gips procedure. This involves making a small cut to drain the abscess. They might prescribe antibiotics if the infection spreads to skin around the cyst.

How Can Parents Help?

To care for a pilonidal cyst at home:

• Clean the area as directed.
• If the doctor tells you to, regularly remove hair from the area by shaving or using a hair removal product. Permanent hair removal, such as laser hair removal, also might be an option.
• Remind your child to avoid sitting for long periods of time.
• Suggest that your child sleep on their side or stomach, which can be more comfortable.

If your child had a pilonidal cyst drained:

• If the doctor prescribed antibiotics, give them as directed.
• Change or remove the bandage as recommended.
• Your child shouldn’t take a bath or swim until the doctor says it’s OK.

What Else Should I Know?

After the infection heals, the doctor may suggest surgery to remove the cyst. Even after surgery, pilonidal cysts sometimes come back. Keeping the area clean and free of hair can help prevent an infection and new cysts.

Reviewed by: Elana Pearl Ben-Joseph, MD

Date reviewed: January 2020

Share:

/content/kidshealth/misc/medicalcodes/parents/articles/pilonidal-cyst

Surgery for pilonidal cyst: MedlinePlus Medical Encyclopedia

URL of this page: //medlineplus. gov/ency/article/007591.htm

To use the sharing features on this page, please enable JavaScript.

A pilonidal cyst is a pocket that forms around a hair follicle in the crease between the buttocks. The area may look like a small pit or pore in the skin that contains a dark spot or hair. Sometimes the cyst can become infected, and this is called a pilonidal abscess.

An infected pilonidal cyst or abscess requires surgical drainage. It will not heal with antibiotic medicines. If you continue to have infections, the pilonidal cyst can be removed by surgery.

There are several types of surgery.

Incision and drainage — This is the most common treatment for an infected cyst. It is a simple procedure done in the health care provider’s office.

• Local anesthesia is used to numb the skin.
• A cut is made in the cyst to drain fluid and pus. The hole is packed with gauze and left open.
• Afterward, it can take up to 4 weeks for the cyst to heal. The gauze has to be changed often during this time.

Pilonidal cystectomy — If you keep having problems with a pilonidal cyst, it can be removed surgically. This procedure is done as an outpatient procedure, so you will not need to spend the night in the hospital.

• You may be given medicine (general anesthesia) that keeps you asleep and pain-free. Or, you may be given medicine (regional anesthesia) that numbs you from the waist down. In rare cases, you may only be given local numbing medicine.
• A cut is made to remove the skin with the pores and the underlying tissue with the hair follicles.
• Depending on how much tissue is removed, the area may or may not be packed with gauze. Sometimes a tube is placed to drain fluid that collects after surgery. The tube is removed at a later time when the fluid stops draining.

It may be hard to remove the entire cyst, so there is a chance that it will come back.

Surgery is needed to drain and remove a pilonidal cyst that does not heal.

• Your provider may recommend this procedure if you have pilonidal disease that is causing pain or infection.
• A pilonidal cyst that is not causing symptoms does not need treatment.

Non-surgical treatment may be used if the area is not infected:

• Shaving or laser removal of hair around the cyst
• Injection of surgical glue into the cyst

Pilonidal cyst resection is generally safe. Ask your provider about these complications:

• Bleeding
• Infection
• Taking a long time for the area to heal
• Having the pilonidal cyst come back

Meet with your provider to make sure medical problems, such as diabetes, high blood pressure, and heart or lung problems are in good control.

Tell your provider:

• What medicines, vitamins, and other supplements you are taking, even ones you bought without a prescription.
• If you are or could be pregnant.
• If you have been drinking a lot of alcohol, more than 1 or 2 drinks a day.
• If you are a smoker, stop smoking several weeks before the surgery. Your provider can help.
• You may be asked to temporarily stop taking blood thinners, such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), vitamin E, clopidogrel (Plavix), warfarin (Coumadin), and any other medicines like these.
• Ask your provider which medicines you should take on the day of your surgery.

On the day of the surgery:

• Follow instructions about whether you need to stop eating or drinking before surgery.
• Take the medicines your provider told you to take with a small sip of water.
• Follow instructions on when to arrive at the hospital. Be sure to arrive on time.

After the procedure:

• You can go home after the procedure.
• The wound will be covered with a bandage.
• You will get pain medicines.
• It is very important to keep the area around the wound clean.
• Your provider will show you how to care for your wound.
• After it heals, shaving the hair in the wound area may help prevent pilonidal disease from coming back.

Pilonidal cysts come back in about one half of the people who have surgery the first time. Even after a second surgery, it may come back.

Pilonidal abscess; Pilonidal dimple; Pilonidal disease; Pilonidal cyst; Pilonidal sinus

Hyman N, Umanskiy K. Anus. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 53.

Johnson EK, Vogel JD, Cowan ML, et al. The American Society of Colon and Rectal Surgeons’ clinical practice guidelines for the management of pilonidal disease. Dis Colon Rectum. 2019;62(2):146-157. PMID: 30640830 pubmed.ncbi.nlm.nih.gov/30640830/.

Wells K, Pendola M. Pilonidal disease and perianal hidradenitis. In: Yeo CJ, ed. Shackelford’s Surgery of the Alimentary Tract. 8th ed. Philadelphia, PA: Elsevier Saunders; 2019:chap 153.

Updated by: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Tailbone cyst (coccygeal passage), treatment at “VERBA MEDICAL” LLC

Mon.-Fri. 09:00 – 17:00

Sat. 09:00 – 15:00

[email protected]

Ave. M.Lushpy 31A

Sumy

Choose a languageRusUkr

Epithelial coccygeal passage (coccygeal cyst) is an acquired or congenital pathology in the sacrococcygeal region, caused by the formation of a cavity under the skin in the intergluteal fold in the form of a tunnel or channel lined from the inside with an epithelium that has the properties of ordinary skin (the presence of hair follicles, sebaceous and sweat glands). This cavity is located at a depth of 2-3 cm, is in no way connected with the coccyx and bones, it may have one or more exits to the skin surface.

This pathology most often develops as a result of impaired intrauterine development. Another reason for the formation of an epithelial coccygeal passage may be the abnormal growth of hair cutting into the skin. This pathology is also called the “jeep” disease, since it develops more often in men with dark skin, increased hairiness, overweight, with a deep intergluteal fold, leading a sedentary lifestyle (drivers, tractor drivers, office workers, etc.)
do not manifest itself for many years and the patient may not even know about its presence.

In the event that an infection gets into the openings of the cyst or an injury develops in the coccygeal passage, an inflammatory process develops. This leads to an increase in the size of the epithelial coccygeal passage and the destruction of its walls. Inflammation passes to the surrounding tissue.

Direct exacerbation and formation of a coccygeal fistula lead to:

• Sedentary work and excess weight
• Non-observance of hygiene rules
• Excessive hairline
• Excessive sweating
• Permanent injury
• Concomitant diseases (diabetes mellitus, dishormonal disorders)

Symptoms of the epithelial coccygeal passage

Exacerbation of the disease is manifested by such symptoms as:

• discomfort in the coccyx and lower back;
• swelling of the skin in the sacrococcygeal region;
• reddening of the skin in the projection of the cyst;
• acute or dull pain, bursting and hoarseness, depending on the severity of the disease in the projection of the coccyx while sitting or walking fast, running.

With prolonged or absent treatment, inflammation progresses, the cyst suppurates, an abscess develops. There is general intoxication, weakness, body temperature rises, headaches, nausea appear. A purulent discharge may be discharged from the fistulous opening.

The chronic form of the disease leads to serious complications:

• opening of the cyst membrane, infection around the lying tissues, development of phlegmon with further spread of its purulent contents into the small pelvis, bone structures of the coccyx and sacrum, soft tissues of the back, etc.;
• infection of the blood with the development of sepsis;
• and the most favorable outcome is the opening of a purulent abscess outwards in the form of a fistula.

Treatment of epithelial coccygeal tract

Epithelial coccygeal tract is a potential focus of inflammation with the formation of purulent infiltrates and fistulas. Conservative treatments can only give temporary results.