Pinlonidal Disease

What is a pilonidal cyst?

A pilonidal cyst is a lump under the skin, located in the crease between the buttocks.  It may cause an infection, or ‘abscess’, under the skin, near or above the tailbone, and may cause pain and swelling in the area.  Sometimes, like a large pimple, the infection either ruptures through the skin by itself, or may need to be opened and drained.  A pilonidal cyst may become infected only once, or may recur in the same place repeatedly.

What causes pilonidal cysts?

Some people are born with a small abnormal area under the skin which later can develop into a pilonidal cyst.  In other cases, the cyst may develop from ingrown hairs between the buttocks.  In most people, there is no definite way to determine whether the cyst has been present from birth or has developed from ingrown hairs.

What can be done about pilonidal cysts?

If an abscess is present, it is important to release the fluid by making a small opening near the cyst.  This is done after first numbing the area using a local anesthetic.  Once the fluid is released, the pain rapidly disappears.  Antibiotics are usually unnecessary after the fluid is drained.

In many cases, this is all that is necessary, and the problem does not recur.  If the cyst becomes infected repeatedly, then an operation may be advisable to remove the cyst itself.  Such an operation must be performed in an operating room, but can usually be accomplished on an outpatient basis, allowing the patient to return home an hour or two after the procedure is completed.  There is usually little postoperative pain, and most patients can return to work within the next day or two.

What are the results of treatment?

Most people are free of further problems from pilonidal cysts after drainage alone, or after surgical removal of the cyst.  However, in some cases, even after an operation, the cyst may return.  The reasons for this are not known; a new cyst may form from an ingrown hair, or it is possible to have another congenital cyst flare up at a later time.  When this happens, an operation can again be performed, again as an outpatient, with the exact nature of the procedure dictated by the nature of the recurrence.