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Pilonidal cyst spine. Pilonidal Cyst: Symptoms, Causes, and Treatment Options

by alexxlab

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.

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Understanding Pilonidal Cysts: An Overview

A pilonidal cyst is a fluid-filled sac that develops near the tailbone, typically at the top of the buttocks crease. While often benign, these cysts can become problematic if infected. The term “pilonidal” comes from the Latin words for “hair” (pilus) and “nest” (nidus), reflecting the common presence of hair within these cysts.

Pilonidal cysts exist in various stages:

  • Cyst – An uninfected, fluid-filled sac
  • Abscess – An infected cyst containing pus
  • Sinus – An opening between the cyst and the skin surface

Are pilonidal cysts serious? While not typically dangerous, infected pilonidal cysts can cause significant discomfort and require medical attention. Understanding the nature of these cysts is crucial for proper management and prevention.

The Etiology of Pilonidal Cysts: Congenital vs. Acquired

Pilonidal cysts can have different origins, broadly categorized as congenital or acquired:

Congenital Pilonidal Cysts

These cysts may stem from developmental defects present at birth. The defect creates a vulnerable area where infection can develop later in life.

Acquired Pilonidal Cysts

Acquired cysts often result from:

  1. Enlargement of a hair follicle infection
  2. Hair penetrating the skin, leading to infection

How do pilonidal cysts form? The formation process typically involves loose hair and dead skin cells becoming trapped beneath the skin. As a person moves, these materials can be pushed deeper, prompting the immune system to form a cyst around the foreign matter.

Risk Factors for Pilonidal Cyst Development

Several factors can increase an individual’s likelihood of developing a pilonidal cyst:

  • Personal or family history of skin conditions (e.g., acne, boils, folliculitis)
  • Excessive body hair, particularly if coarse or thick
  • Tailbone injury
  • Prolonged sitting or activities like horseback riding and cycling
  • Obesity
  • Tight clothing that puts pressure on the tailbone area
  • Presence of a dimple or pit in the tailbone region

Why are young men more prone to pilonidal cysts? The combination of hormonal factors, typically higher body hair levels, and engagement in activities that involve prolonged sitting may contribute to the increased prevalence in this demographic.

Recognizing Pilonidal Cyst Symptoms

Pilonidal cysts may be asymptomatic when uninfected. However, an infected cyst (pilonidal abscess) can present with various symptoms:

  • Pain and swelling over the sacrum (just above the tailbone)
  • Redness in the affected area
  • Drainage of pus or blood from a sinus tract
  • Foul odor
  • Fever (in some cases)

Can pilonidal cysts cause long-term complications? If left untreated, infected pilonidal cysts can lead to chronic infection, sinus tract formation, and in rare cases, squamous cell carcinoma. Prompt medical attention is crucial when symptoms arise.

Diagnosis and Medical Assessment of Pilonidal Cysts

Diagnosing a pilonidal cyst typically involves a straightforward process:

  1. Medical history review
  2. Physical examination
  3. Assessment of symptoms and cyst location

In most cases, no additional diagnostic tests are required. The characteristic location and appearance of the cyst are usually sufficient for diagnosis.

Is imaging necessary for pilonidal cyst diagnosis? While rarely needed, imaging studies like MRI or ultrasound may be used in complex cases or to rule out other conditions.

Treatment Approaches for Pilonidal Cysts

The treatment of pilonidal cysts depends on the severity of the condition and the patient’s overall health. Options include:

Conservative Management

For minor, uninfected cysts:

  • Hot water soaks to promote drainage
  • Proper hygiene and hair removal in the affected area

Incision and Drainage

For infected cysts (abscesses):

  • Lancing the abscess
  • Draining the pus
  • Packing the wound with sterile gauze

Surgical Excision

For recurrent or severe cases:

  • Complete removal of affected tissue
  • Wound closure with sutures or left open to heal from inside out

Laser Hair Removal

Emerging treatment option:

  • Reduces hair in the area to prevent recurrence
  • May be effective in treating and preventing pilonidal cysts

How effective is surgical treatment for pilonidal cysts? While surgery can be highly effective, recurrence rates vary. Studies suggest recurrence rates between 5-30% depending on the surgical technique and post-operative care.

Preventing Pilonidal Cysts: Practical Strategies

Several measures can help reduce the risk of developing pilonidal cysts:

  1. Maintain proper hygiene in the tailbone area
  2. Keep the area clean and dry
  3. Avoid prolonged sitting on hard surfaces
  4. Engage in regular physical activity to prevent obesity
  5. Consider hair removal in the affected area
  6. Wear loose-fitting clothing to reduce pressure on the tailbone

Is hair removal effective in preventing pilonidal cysts? While not a guaranteed prevention method, regular hair removal in the tailbone area can significantly reduce the risk of cyst formation by minimizing the amount of hair that could potentially become trapped under the skin.

Living with Pilonidal Cysts: Management and Lifestyle Adaptations

For individuals prone to pilonidal cysts or those recovering from treatment, certain lifestyle adaptations can be beneficial:

  • Use cushions or specialized seating aids to reduce pressure on the tailbone area
  • Take regular breaks from sitting during long periods of work or travel
  • Maintain a healthy weight through diet and exercise
  • Practice good posture to minimize friction and pressure in the affected area
  • Consider using antibacterial washes or wipes to keep the area clean

Can pilonidal cysts recur after treatment? Yes, recurrence is possible, especially if risk factors persist. Adhering to preventive measures and maintaining good hygiene are crucial in reducing the likelihood of recurrence.

Psychological Impact and Support

Living with pilonidal cysts can have psychological effects, including:

  • Embarrassment or self-consciousness
  • Anxiety about recurrence
  • Discomfort in social situations

Seeking support from healthcare providers, support groups, or counseling services can be beneficial in managing these emotional aspects.

Advances in Pilonidal Cyst Research and Treatment

Ongoing research in the field of pilonidal cyst management is exploring new treatment modalities and prevention strategies:

Minimally Invasive Techniques

Emerging procedures aim to reduce recovery time and scarring:

  • Endoscopic pilonidal sinus treatment (EPSiT)
  • Pit picking techniques
  • Fibrin glue application

Biological Therapies

Investigations into the use of biological agents to promote healing:

  • Platelet-rich plasma (PRP) therapy
  • Growth factor applications

Genetic Studies

Research into genetic factors that may predispose individuals to pilonidal cysts could lead to more targeted prevention and treatment strategies.

How might future treatments for pilonidal cysts differ from current approaches? Future treatments may focus more on preventive measures, personalized risk assessment based on genetic factors, and less invasive treatment options that promote faster healing and reduce recurrence rates.

Pilonidal Cysts in Special Populations

While pilonidal cysts are most common in young adults, they can affect individuals across different age groups and populations:

Pediatric Pilonidal Cysts

Management in children and adolescents may differ:

  • Conservative treatment is often preferred
  • Surgery is considered for recurrent or severe cases
  • Education on hygiene and prevention is crucial

Pilonidal Cysts in Pregnancy

Pregnant women may face unique challenges:

  • Limited treatment options due to pregnancy
  • Increased discomfort due to weight gain and hormonal changes
  • Focus on conservative management and symptom relief

Occupational Considerations

Certain professions may have a higher risk of developing pilonidal cysts:

  • Long-distance drivers
  • Office workers with prolonged sitting
  • Military personnel (historically known as “Jeep disease”)

Do pilonidal cysts affect men and women equally? While pilonidal cysts can occur in both sexes, they are more common in men, possibly due to higher levels of body hair and engagement in activities that involve prolonged sitting.

Complementary and Alternative Approaches to Pilonidal Cyst Management

While medical and surgical treatments remain the primary approaches, some individuals explore complementary methods to manage pilonidal cysts:

Herbal Remedies

Some natural treatments that may offer relief:

  • Tea tree oil for its antimicrobial properties
  • Aloe vera for soothing and anti-inflammatory effects
  • Castor oil packs to promote drainage

Dietary Modifications

Nutritional approaches that may support healing:

  • Increasing intake of anti-inflammatory foods
  • Ensuring adequate hydration
  • Supplements to support skin health and immune function

Stress Reduction Techniques

Managing stress may aid in overall healing and prevention:

  • Meditation and mindfulness practices
  • Yoga or gentle stretching exercises
  • Adequate sleep and rest

Can alternative therapies replace conventional treatments for pilonidal cysts? While complementary approaches may offer symptomatic relief and support overall health, they should not replace medical treatment, especially for infected or severe cases. Always consult with a healthcare provider before trying alternative therapies.

The Economic and Social Impact of Pilonidal Cysts

Pilonidal cysts can have broader implications beyond individual health:

Healthcare Costs

The financial burden of pilonidal cyst treatment includes:

  • Direct medical costs for diagnosis and treatment
  • Potential costs of repeated treatments for recurrent cases
  • Expenses related to wound care and follow-up visits

Work and Productivity

The impact on professional life can be significant:

  • Time off work for treatment and recovery
  • Reduced productivity due to discomfort
  • Potential career limitations in certain professions

Quality of Life

Pilonidal cysts can affect various aspects of daily life:

  • Limitations on physical activities and exercise
  • Social discomfort and potential isolation
  • Impact on intimate relationships

How can the societal impact of pilonidal cysts be mitigated? Increased awareness, early intervention, and improved workplace accommodations can help reduce the overall impact of pilonidal cysts on individuals and society.

Future Directions in Pilonidal Cyst Management

The field of pilonidal cyst management continues to evolve, with several promising areas of development:

Personalized Medicine Approaches

Tailoring treatment based on individual factors:

  • Genetic profiling to assess risk and guide prevention
  • Customized treatment plans based on cyst characteristics and patient history

Advanced Wound Healing Technologies

Innovations in wound care for faster recovery:

  • Smart dressings with antimicrobial and healing-promoting properties
  • Tissue engineering approaches for complex cases

Telemedicine and Remote Monitoring

Leveraging technology for improved care:

  • Virtual consultations for follow-up and minor issues
  • Wearable devices for early detection of inflammation or infection

What role might artificial intelligence play in pilonidal cyst management? AI could potentially assist in early diagnosis, predicting treatment outcomes, and optimizing personalized treatment plans based on vast datasets of patient information and treatment results.

As research progresses and new technologies emerge, the management of pilonidal cysts is likely to become more effective, less invasive, and more tailored to individual needs. Continued education, awareness, and interdisciplinary collaboration will be key in advancing care for individuals affected by this condition.

Pilonidal Cyst | UVA Health

A pilonidal cyst is a fluid-filled developmental defect at the base of the spine.

The terms cyst, sinus, and abscess refer to different stages of the disease process.

  • Cyst — not infected
  • Abscess — pocket of pus
  • Sinus — opening between a cyst or other internal structure and the outside

While the cyst is not serious, it can become an infection and should therefore be treated. When a pilonidal cyst gets infected, it forms an abscess, eventually draining pus through a sinus. The abscess causes pain, a foul smell, and drainage.

This condition is not serious. But, since it is an infection, it can enlarge and become uncomfortable. Therefore, it should be treated.

Pilonidal Cyst Copyright © Nucleus Medical Media, Inc.

Pilonidal Cyst Causes 

A pilonidal cyst may be congenital or acquired. If congenital, it probably began as a defect that existed when you were born. Sometime later, the defect allowed an infection to develop. If acquired, it may be the enlargement of a simple hair follicle infection or the result of a hair penetrating the skin and causing an infection.

Risk

The following factors increase your chance of developing a pilonidal cyst:

  • Personal or family history of similar problems such as acne, boils, carbuncles, folliculitis, and sebaceous cysts
  • Large amounts of hair in the region
  • Tailbone injury
  • Horseback riding, cycling
  • Prolonged sitting
  • Obesity

Symptoms

Symptoms may include:

  • Painful swelling over your sacrum, which is the area just above your tailbone
  • A foul smell or pus draining from that area

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. You will be referred to a surgeon for treatment. There are no diagnostic tests required.

Treatment

Talk with your doctor about the best treatment plan for you. The choice of treatment will depend on the extent of the condition and your general overall health. Treatment options include:

Home Treatment

As with all localized infections under the skin, hot water soaks will draw out the infection. This will not completely cure the condition, but it will help.

Incision and Drainage

The abscess is lanced, the pus drained, and the wound is packed with sterile gauze. This helps it heal from the inside out. But, this usually does not cure the problem because abnormal tissue remains.

Excision

To completely cure the condition, all affected tissue needs to be removed. This is a more extensive surgical procedure than simple incision and drainage. The surgical wound may be closed with sutures or left open to heal from the inside.

Laser Hair Removal

There are recent reports that laser hair removal in the area may be an effective treatment for pilonidal cysts.

Prevention

Here are ways to reduce your chance of getting a pilonidal abscess:

  • Keep the area clean and dry.
  • Avoid sitting for a long time on hard surfaces.
  • Remove hair from the area.

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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Pilonidal cyst – article

Pilonidal cyst, epithelial pilonidal cyst – a congenital disease, the formation of a cystic cavity from skin cells in the projection of the coccyx and sacrum. It can fester and externally manifests itself as an infiltrate or abscess.

Epithelial coccygeal passage – a congenital epithelial immersion in the sacrococcygeal region – outwardly manifests itself as a depression, a funnel, a passage from which hair often stands out. The epithelial coccygeal passage is subject to inflammation. Often inflammation and suppuration are repeated. Purulent fistulas may form.

Epithelial coccygeal cysts and moves must be operated on.

We operate on such patients in different ways, depending on the specific situation of the individual manifestation of coccygeal cysts and passages. The meaning of operations is to radically remove the affected tissues, which will avoid relapses. We use methods of radio wave surgery and author’s methods of treatment.

The author of the article:

Ivanova Natalya Vladimirovna

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