Pilonidal Cyst

What’s a pilonidal cyst?

A pilonidal cyst is a growth caused by a hair follicle that becomes infected. Typically, pilonidal cysts are found at the very top of the buttocks, where the crease ends at the tailbone.

A pilonidal cyst forms around an infected ingrown hair follicle causing a deep cavity below the surface of the skin, which is filled with hair, debris, and infectious material. This infection can progress, causing inflammation and pain.

Pilonidal cysts can be chronic, meaning they can be drained, treated with antibiotics, heal, and then return. For most, surgery is eventually needed to remove the cyst and close the cavity created by the cyst.

What causes pilonidal cysts?

Pilonidal cysts are formed when a hair is forced back down into the hair follicle, which becomes blocked and infected. Hair that’s stiff or coarse has a higher potential for causing this type of cyst.

It’s not entirely clear why pilonidal cysts form, but risk factors include:

• Being male
• Being obese
• Having excessive body hair
• Having a sedentary lifestyle
• Wearing clothes that rub the area above your buttocks
• Sitting for prolonged periods of time
• Bouncing on tailbone with “Jeep Disease”

Usually, pilonidal cysts form in younger people from puberty to about age 40 and this “Jeep Disease” afflicted many hairy men in our military service.

What are the symptoms of a pilonidal cyst?

If you have one or more pilonidal cyst, symptoms can include:

• A palpable mass or growth near the crease of your buttocks
• Swelling and redness
• Pain and/or tenderness
• Drainage from the growth

Pilonidal cysts can return. They’re often larger and more severe when they do. When this happens, surgical removal is probably your best option.

How does surgery treat a pilonidal cyst?

Pilonidal cysts form a cavity below the surface of the skin that grows larger over time and with recurrent cysts. This space is ideal for a lingering infection, which is the reason that cysts often return.

Surgery is needed to remove all infectious material associated with the cyst, and to close the cavity beneath the skin. There are two primary approaches to closing the cavity:

Open healing

The surgeon removes the cyst and leaves the cavity open to allow the tissue to heal from the inside out. Healing usually takes a long time and is rarely offered by surgeons at Progressive Surgical Care.

Primary closure

The surgeon removes the cyst and then surgically closes the cavity using flaps of muscle and skin. This seals the cavity and allows quicker healing.  

Progressive Surgical Care utilizes the primary closure method. It’s important to follow your provider’s post-operative instructions carefully, to ensure that you heal effectively and prevent reinfection at the site. Their team is with you every step of the way. Sutures are left in place for 10-14 days in this sensitive area to assure complete closure.

For a consultation about your pilonidal cyst, call or schedule an appointment online today with Progressive Surgical Care.