A pilonidal cyst is a small pouch or sac in the skin that commonly forms on the tailbone at the top of the buttocks 2. These cysts can fill with debris such as dead hair which pushes through the skin, creating a sinus cavity that can easily become infected. In most cases, pilonidal cysts can be treated effectively with cleaning and sterilization, or by draining any areas of infection. Some people who experience recurring infections, however, may require surgery.
Medication and Cleansing
To prevent and treat infection of pilonidal cysts, doctors may prescribe antibiotics, according to CIGNA health 4. Patients may also treat the cyst by cleaning it regularly with a mixture of antibacterial soap and water or by taking a soothing, medicated bath. Patients with painful, infected sores may also be advised to take over-the-counter nonsteroidal anti-inflammatory medications like acetaminophen or ibuprofen to help ease the pain, according to the University of Michigan Health System 3.
How to Lance a Wound
When pilonidal cysts become infected, they turn into pus- or fluid-filled abscesses. The first line of treatment for an infected pilonidal cyst is typically to drain this fluid from the wound 2. After numbing the cyst with a local anesthetic, a doctor uses an instrument to open the sore, extract the pus and sterilize the abscess by removing dirt, hair and debris from the wound and surrounding skin. To keep the cyst protected from further infection and to promote healing, the physician usually packs the open wound with sterile gauze. According to MayoClinic.com, up to 60 percent of all patients with infected pilonidal cysts require no additional treatment after such drainage.
- When pilonidal cysts become infected, they turn into pus- or fluid-filled abscesses.
- The first line of treatment for an infected pilonidal cyst is typically to drain this fluid from the wound 2.
Patients with pilonidal cysts that repeatedly become infected may require surgery. According to FamilyDoctor.org, there are two common surgical approaches used to treat these infections 2. In the first approach, a surgeon makes an incision into or right next to the cyst and cleans the abscess and infected sinus pocket beneath the skin. He then closes the wound with stitches. In the second approach, the physician makes an incision into the cyst, drains and cleans it, covers it with gauze, then leaves it open to heal. The Mayo Clinic notes that, compared with the closed-wound surgical procedure, this approach poses less risk of recurring infection; however, healing generally takes significantly longer and the sterile dressings require regular changing to keep the area clean.
- Patients with pilonidal cysts that repeatedly become infected may require surgery.
- In the second approach, the physician makes an incision into the cyst, drains and cleans it, covers it with gauze, then leaves it open to heal.
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- Mayo Clinic: Pilonidal Cyst Treatments
- FamilyDoctor.org: Pilonidal Cyst
- University of Michigan Health System: Pilonidal Cyst
- CIGNA Health: Pilonidal Disease
- U.S. National Library of Medicine: MedlinePlus. Surgery for pilonidal cyst. Updated May 7, 2020.
- American College of Colon and Rectal Surgeons. Pilonidal disease.
- Onder A, Girgin S, Kapan M, et al. Pilonidal sinus disease: risk factors for postoperative complications and recurrence. Int Surg. 2012;97(3):224‐229. doi:10.9738/CC86.1
- Bendewald FP, Cima RR. Pilonidal disease. Clin Colon Rectal Surg. 2007;20(2):86-95. doi:10.1055/s-2007-977486
- Stauffer VK, Luedi MM, Kauf P, et al. Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence. Sci Rep. 2018;8(1):3058. doi:10.1038/s41598-018-20143-4
- American College of Surgeons. Medication and surgery: before your operation. Updated May 2019.
- Milton S. Hershey Medical Center. Surgery for pilonidal cyst. Updated May 27, 2019.
- George Washington University Medical Faculty Associates. Post-operative instructions for pilonidal excision.
- Oram Y, Kahraman F, Karincaoğlu Y, Koyuncu E. Evaluation of 60 patients with pilonidal sinus treated with laser epilation after surgery. Dermatol Surg. 2010;36(1):88-91. doi:10.1111/j.1524-4725.2009.01387.x
- Benedetto AV. Commentary: hair and pilonidal sinus disease. Dermatol Surg. 2010;36(1):92-93. doi:10.1111/j.1524-4725.2009.01388.x
Based in New York City, Tricia Mangan began her writing career in 2001. She has co-authored a National Cancer Institute report and a number of research articles that have appeared in medical journals. Tricia holds a Master of Arts in clinical psychology from Stony Brook University and boasts diverse clinical, research and teaching experience.