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

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What Is Pilonidal Cyst? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Signs and Symptoms of Pilonidal Cyst

Symptoms of a pilonidal cyst include: (1)

• Pain or tenderness
• Swelling
• Skin reddening
• Draining of pus or blood (sometimes with a foul smell)

Sometimes, a pilonidal sinus develops. This is an opening that grows under the skin from the hair follicle. (3)

Treatment isn’t typically needed for cysts that don’t cause symptoms, but for those that are swollen, tender, and infected, you should seek out medical help, because in these cases, treatment is necessary. (4)

Common Questions & Answers

Will a pilonidal cyst go away on its own?

Some pilonidal cysts don’t require treatment and drain on their own. But these cysts can return. Treatment is necessary for a cyst that comes and goes, is bothersome, or becomes infected. Your doctor can drain or surgically remove the cyst.

What causes a pilonidal cyst?

Pilonidal cysts occur when loose hairs get trapped underneath the skin near the tailbone. Your body treats this hair as a foreign object and forms a cyst around it. Activities that cause pressure and friction can trigger a pilonidal cyst, such as sitting for prolonged periods, biking, and wearing tight clothes.

How do you get rid of a pilonidal cyst at home?

To ease pain and discomfort, and to encourage a pilonidal cyst to drain, apply a hot, wet compress to the affected area several times a day or take a warm bath. This can help the cyst open.

How serious is a pilonidal cyst?

A pilonidal cyst isn’t a serious condition, but complications can occur in certain cases. For example, these cysts may increase the risk of a skin cancer called squamous cell carcinoma, and some cysts can trigger a life-threatening full-body infection.

How can I stop my pilonidal cyst from coming back?

To prevent a pilonidal cyst from returning, avoid sitting for prolonged periods of time. You can also shave near your tailbone to prevent ingrown hairs in this area. Losing weight can also lower your risk, as well as keeping this area clean and dry.

Causes and Risk Factors of Pilonidal Cyst

Experts don’t agree on exactly what causes pilonidal cysts. If you sit for prolonged periods or wear tight clothing, you may be at higher risk of getting these cysts. (5)

Some believe ingrown hairs (loose hairs that reenter the skin) are triggers. The skin then responds to the hair as if it were a foreign body and forms a cyst around it. (4)

This chain of events explains pilonidal cysts that affect body parts other than the tailbone area. For instance, the cysts can develop in the skin between the fingers among barbers and dog groomers because hairs can become lodged in this space. (1)

According to another theory, as deep layers of the skin stretch, the hair follicle enlarges and ruptures, and then a cyst forms around the follicle that ruptures. The follicle is the structure from which a hair grows out. (6)

Some experts believe pilonidal cysts occur after trauma to that body area.

Many World War II soldiers, for example, had pilonidal cysts. Experts blamed those cysts on the chronic irritation that occurred when the soldiers rode in jeeps over bumpy terrain. (7)

The condition was even known as “jeep disease” for a time.

Some factors may increase the risk of getting a pilonidal cyst. Among them: (5)

• Being obese
• Being inactive
• Working at a job that requires long sitting times (such as truck driving)
• Having excess body hair
• Having stiff or coarse hair
• Having poor hygiene

Sometimes, pilonidal cysts are hereditary. Rough body hair and ingrown hairs may run in your family, increasing your risk of developing a cyst. (5)

Resources We Love

Favorite Organizations for Essential Pilonidal Cyst Information

KidsHealth

Although pilonidal cysts are more common among young men, it can affect children, too. KidsHealth provides information to help you identify this skin condition in your child. You’ll also find advice on ways to treat this condition at home.

Cleveland Clinic

Whether you need information on prevention, treatment, or diagnosis, the Cleveland Clinic gives a comprehensive overview of pilonidal cysts. You’ll find answers to common questions about this condition, as well as other helpful wellness information.

American Society of Colon and Rectal Surgeons (ASCRS)

The ASCRS provides a thorough overview of pilonidal cysts and other useful resources related to this condition. This includes images and video explaining causes and symptoms.

Best Online Support Network

Pilonidal Support Alliance

If you have pilonidal disease, this website is an excellent place to learn more about your condition and receive support from a community. You can share your personal story, read the experiences of others, or drop by the patient forum to ask a question or get tips.

Favorite Site for Telemedicine

MDLive

Think you might have a pilonidal cyst? If you have questions, concerns, or need a diagnosis, you can speak with an online dermatologist anytime, anywhere. Simply upload a photo of your skin. For treatment, though, you’ll need to see a local doctor.

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Epithelial coccygeal tract – causes, symptoms, treatment, operation to excise ECX

Epithelial coccygeal passage (ECC) is a congenital disease in which a subcutaneous canal is formed in a person in the intergluteal region, leading to the cyst cavity in the fatty tissue of the coccyx region. This formation looks like a small hole in the skin, it is located strictly along the midline between the buttocks in the projection of the coccyx, the lower part of the sacrum. The epithelial passage has other names – fistula or pilonidal cyst. According to the experience of doctors, this disease is more common in men than in women. EMC offers a highly effective treatment for ECC. The technologies used in the clinic provide a quick recovery after the removal of the coccygeal passages.

Benefits of epithelial coccygeal tract treatment at EMC

Modern equipment for diagnostics before, after and during surgical treatment

Highly qualified surgeons with vast experience in surgical treatment of the epithelial course, who have completed training in leading clinics in the world

Individual rehabilitation program for each patient after removal of the coccygeal passages. The program can be completed both outpatient and inpatient at the EMC Rehabilitation Center at Rublevo-Uspenskoye Highway, 187

Modern electrosurgical equipment for surgical treatment with less blood loss and a faster rehabilitation period after removal of the coccygeal cysts

Treatment of patients with epithelial course at all stages is carried out by a multidisciplinary team of doctors

Causes of disease

Epithelial coccygeal passage is a congenital disease that develops due to mutations and breakdowns in the genome. There are no other proven causes of ECC. According to one hypothesis, the cyst may be an acquired disease that is associated with the reverse direction of hair growth. They, in turn, deepen and grow into the subcutaneous fat layer. For this reason, fistulas are formed.

Symptoms of coccygeal passage

The epithelial coccygeal passage for a long time can proceed without any special signs. Chronic inflammation is manifested by the following symptoms: blood or pus flows from the fistulas, there is slight pain, swelling, and sometimes redness appears. Also, traces of discharge from the intergluteal crease may remain on the underwear during ECX. In acute inflammation and infection, patients develop symptoms such as high fever, a person cannot sit, and it is impossible to touch the area of ​​the epithelial coccygeal passage due to severe pain. These symptoms may indicate the presence of abscesses.

Pilonidal cyst types

Types of coccygeal cysts are classified depending on the presence of symptoms. If there are no symptoms, the cyst is characterized only by visual signs. In this case, it is the presence of a primary opening of the pilonidal coccygeal cyst. The second type is associated with an acute abscess of the epithelial coccygeal passage. Usually, the patient develops inflammation against the background of playing sports, weakening the immune system, and insufficient hygiene of the intergluteal fold. An infection penetrates into the ECC and provokes the multiplication of microbes, which leads to suppuration. As a result, symptoms such as mucus secretion and the occurrence of an ECC abscess appear. In this case, inflammation can subside and temporarily do not give symptoms, and then recur and lead to the appearance of repeated abscesses and the formation of multiple fistulas. In this case, ECX requires emergency surgery.

ECX diagnostics

A preventive examination by a doctor allows you to determine the presence of a primary opening of the ECX. Sometimes in patients with a coccygeal tract, they can be very small and dotted. The most accurate research method for ECC is magnetic resonance imaging (MRI) with intravenous contrast, which allows you to distinguish healthy tissue from cystic and notice inflammation. Also, if ECC is suspected, an ultrasound examination (ultrasound) can be used.

Treatment of epithelial coccygeal tract

Doctors recommend removing the coccygeal passage. The sooner the surgical intervention is performed, the easier the operation and the greater the chances of a complete recovery after removal of the ECC, as well as the low likelihood of re-inflammation. A coccygeal cyst is treated much more effectively in a “calm” period without inflammation, before the appearance of abscesses. If the patient comes with an acute phase of the inflammatory process of ECC, and he has suppuration, then a two-stage operation is required. It consists of drainage of an acute purulent process and subsequent removal of the entire cyst with secondary formations.

Pilonidal cyst drainage can be done on an outpatient basis and performed under local anesthesia. The first task of the doctor is to eliminate inflammation. The surgeon opens the abscess, puts a drain, rinses the wound. Hospitalization for ECX in this case is not required. The division of treatment into stages allows you to wait for the period when the wound is cleared and the patient does not have suppuration: in the “calm” period, the operation is performed.

If the epithelial coccygeal cyst is in a chronic form, without inflammation, suppuration and abscesses, then in this case the surgical treatment is one-stage: the cyst is removed, then, within one surgical intervention, the doctor can perform plastic surgery. MRI is required before and after surgical treatment of ECC. There are standard treatments for epithelial coccygeal tract (ECH) and the more modern Karidakis operation. During the surgical intervention, excision of the ECC is performed. All methods of treating a coccygeal cyst have their pros and cons, but none of them guarantees a 100% absence of re-inflammation and relapse after treatment.

Standard Excision Methods ECX

Surgery to remove a pilonidal cyst with suturing the edges of the wound has long been the gold standard for the treatment of epithelial coccygeal ducts around the world. This is a radical surgical intervention, which, despite its effectiveness, is quite traumatic and associated with certain discomfort. So, patients cannot sit normally for a long time after the removal of ECX. Then there were operations Bascom-1, Bascom-2 – removal of primary holes with cleaning of the cavity from the inside with special tools. In any case, this is also a radical operation, but with a shorter rehabilitation period than the first method. The main problem was that the incision site for removing the coccygeal passages is very vulnerable, where the right and left blood flow meet. Any wound located in the middle of the back experiences even less blood flow when pulled. When the surgeon sutures the edges of the skin, an open wound is formed there, which heals for a long time and slowly after the removal of the ECC.

Stroke resection

Operation on Karidakis with epithelial coccygeal passage.

This is a radical method of surgical treatment: an operation is performed to remove the ECC with a near-median approach. The method was patented in 1976 by the army surgeon G.E. Karydakis. During this method of treating a cyst, the surgeon makes an incision not in the midline, but next to the intergluteal fold to remove it. After such treatment, rehabilitation is faster, and the likelihood of recurrence of coccygeal passages is significantly reduced. The operation on Karidakis has the only disadvantage – the asymmetry of the buttocks after the removal of the coccygeal passages. In EMC, surgeons, performing similar treatment, minimize this defect, find a way to make the suture after surgical treatment of the coccygeal cyst less noticeable. So, the incision after removal of the cyst is sutured with a complex layered multi-story suture, which is then removed. This gives a very good result. In addition, EMC uses modern electrosurgical equipment, which makes it possible to operate patients more efficiently and without severe blood loss and to remove the coccygeal passages. All this has a positive effect on the outcome of surgical treatment, reduces the time of rehabilitation and the likelihood of re-inflammation.

Treatment of the epithelial coccygeal passage in the EMC is carried out by:

Possible complications after surgery

As after any surgical treatment, infectious complications are possible after removal of the epithelial coccygeal passage. EMC surgeons performed a huge number of operations to remove epithelial coccygeal passages. In addition to the colossal experience, the success of operations is also ensured by modern electrosurgical equipment, which is in the arsenal of EMC surgeons.

In addition, in addition to the coccygeal passages, patients may have concomitant diseases that will make themselves felt after the operation. It is very important that a multidisciplinary team of doctors of different categories is responsible for the treatment of the patient at all stages. For this reason, in EMC, before surgical treatment, the patient is examined by therapists, cardiologists, and anesthesiologists. A comprehensive examination and the adoption of a collective decision of doctors to conduct a surgical intervention make it possible to avoid complications after the removal of the coccygeal passages in the future.

ECC prophylaxis

Since the epithelial coccygeal tract is a congenital disease, there are no methods of prevention. But there are tips to help prevent inflammation and abscesses in the intergluteal region and around the anus.

It is necessary to follow the rules of hygiene from birth, if the baby has signs of the disease, contact a pediatric surgeon or coloproctologist. Prior to this, daily treat the child with ECX Miramistin. These simple rules help to avoid the multiplication of microbes and the subsequent occurrence of inflammation.

• It is also important not to wear tight or overly tight clothing, be physically active, and remember to clean the area after removing the ECC after sports.

These preventive methods are classified as conservative treatment of ECC, but it is ineffective: according to doctors, the coccygeal cyst needs to be removed, you should not wait for the development of a more acute course of the disease and the onset of inflammation.

Ask a question about the operation

Rehabilitation period after surgical treatment of epithelial coccygeal passage

1. In EMC, doctors help the patient to stand on his feet on the 2nd day after the operation to remove the ECC, and he can move independently around the ward under the supervision of specialists.
2. Then the patient is discharged, and the final recovery takes place in comfortable conditions at home, under the outpatient supervision of the operating coloproctologist.
3. In the first two weeks after surgical treatment, the sutures are removed and the patient is observed on an outpatient basis for six months.
4. After removing the sutures, it is important for the patient to ensure that the area of ​​surgical intervention is not injured, to follow the rules of hygiene in order to exclude injury and infection.
5. In order for all tissues to heal thoroughly after removal of the coccygeal cyst, it takes about six months after the operation.
6. It is also important to maintain a healthy lifestyle and try to stop smoking in order to speed up the recovery process after ECC removal.
7. If a patient develops pathological scars or re-inflammation, it is important to immediately consult a specialist and not treat yourself.

Cost of treatment

It is possible to calculate the cost of epithelial coccygeal duct treatment in EMC after an individual consultation with a doctor.

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Pilonidal cyst of the coccyx – causes, symptoms, diagnosis, treatment and prevention

• What you need to know about the pilonidal cyst of the coccyx?
• Diagnostics and treatment of coccyx cysts in ON CLINIC
• Doctors
• Shares

So, the pilonidal cyst of the coccyx is a congenital defect in the development of the skin, when a narrow epithelial hollow tube is formed in the gluteal fold, which is in no way connected with the coccyx or sacrum.

In medicine, this phenomenon has many names, for example, “coccyx fistula”, “epithelial coccygeal passage”, “pilonidal sinus” and so on. More often this rudimentary formation occurs in men.

The coccyx cyst brings such inconveniences as a constant feeling of discomfort, suppuration, redness, burning and other unpleasant symptoms. Of course, it would be wrong to think that the cyst will eventually disappear on its own. To get rid of this pathology, you need to contact a specialist, or rather, a surgeon.

Get rid of the pilonidal cyst will help you in the International Medical Center ON CLINIC.

Experienced surgeons of our center have been specializing in this type of operations for many years. Therefore, we can say with confidence: the removal of a coccyx cyst in ON CLINIC is a safe and reliable procedure.

What you need to know about the pilonidal cyst of the coccyx?

Causes of coccyx cyst development

Causes of coccyx cysts can be:

• sedentary work;
• infections;
• inflammation of sweat glands or hair follicles;
• reduced immunity;
• uncomfortable tight clothing;
• injuries in the coccyx area and so on.

Pilonidal cyst symptoms

The following symptoms may indicate that it is time for you to consult a doctor:

• 7-10 cm above the anus, redness, hole, swelling or induration may form, which will cause discomfort and pain when walking;
• purulent discharge may begin in the area of ​​the cyst;
• in case of infection in the fistula, as a rule, severe suppuration begins, the temperature rises and acute pain appears in the coccyx area.

Do not delay in contacting a specialist if you want to avoid health problems in the future. Our doctors are happy to assist you at any time convenient for you, seven days a week. We work without weekends and holidays. Contact us!

Discount for initial doctor’s appointment until June 30Promotion -15%

Initial appointment with a doctor whose specialization you have never been to, including ON CLINIC Baby, with a discount – from 2 125 ₽ instead of 2 500 ₽ .

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Diagnostics and treatment of coccyx cysts in ON CLINIC

It is possible to diagnose a coccyx cyst during a visual examination, taking into account the patient’s complaints. However, there is a danger of confusing a cyst with a rectal fistula or osteomyelitis. That is why you need to seek help only from good specialists. It is possible to make a final diagnosis only after probing the course, sigmoidoscopy, and sometimes radiography of the coccyx. You can undergo all these procedures in our multidisciplinary center.

We employ proctologist surgeons with vast experience in diagnosing diseases of any etiology. In our clinic, examinations are carried out only on the equipment of leading manufacturers of medical equipment. You can be sure: diagnostics at ON CLINIC is fast, comfortable and accurate.

As for the treatment of pilonidal cysts, ON CLINIC specialists agree with the world luminaries of proctology, who believe that the only way to get rid of the coccyx fistula is by surgery.

And remember: you do not need to experiment on your health. Ointments and traditional medicine can only bring temporary relief. A recurrent abscess, suppuration and the appearance of multiple fistulas – this is what you can expect if you do not operate on the coccyx cyst in time.

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