What is Pilonidal Cyst?

Pilonidal cysts are a fairly common diagnosis, especially in young men. These cysts typically occur at the top of the intergluteal cleft, near the tailbone. They are often found in the cleft itself, between the two sides of the buttocks. Unfortunately, these cysts have a tendency to become painfully infected. If diagnosed early, your proctologist, also known as a colon and rectal surgeon, may be able to help you prevent further infection and the inflamed cyst will clear on its own.

What Causes The Cysts?

Medical research has not pinpointed the exact cause of pilonidal cysts. Some believe they are present from birth surrounding a hair follicle, while others think they are caused by an ingrown hair or other trauma later in life. Because men have much more body hair than women, they are more susceptible to the cysts and related abscesses.

Other factors that may increase your risk of developing the cysts include poor personal hygiene, obesity, a job that requires sitting most of the day, tight clothing and certain activities that put pressure on the area, such as bicycling and horseback riding. The disease was called jeep driver’s disease in the past because young men who drove jeeps in the military seemed to develop pilonidal disease. While pilonidal cysts cannot be prevented, in many cases, your doctor will be able to make recommendations on how to reduce your risk of infection.

How Will I Know If I Have a Pilonidal Cyst?

Some people with a pilonidal cyst don’t have any symptoms, especially if the cyst isn’t infected. Most, however, realize they have a problem when they experience pain or discomfort when they are sitting. This may be exacerbated by some activities, such as riding a bike. You may also notice swelling near the tailbone. Some people also report excess moisture in the area, including pus or bloody discharge. Other signs of an abscess include inflamed skin, elevated body temperature and a foul odor coming from the wound.

In some cases, the infected cysts may completely drain on their own through a small hole that is created between the cyst and the surface of the skin. When this occurs, it is known as a pilonidal sinus. This draining may actually reduce the pain and swelling associated with an abscessed cyst, although treatment is skill necessary.

Do I Need to See A Doctor?

Only a qualified medical professional can properly diagnose and treat a pilonidal cyst or sinus. Because of the high risk for infection or recurrence, it is important to see a doctor if you notice any symptoms that may be a pilonidal cyst. It is also important to see a doctor as soon as possible, because a cyst in this area can become infected quickly.
While many general practitioners are equipped to diagnose a pilonidal cyst, infected and recurring cysts are often treated by a proctologist. These doctors are trained as colon and rectal surgical specialists, and can offer the best chance of recovery without recurrence. Another advantage to being seen by a colon and rectal surgeon is that they are less likely to misdiagnose your condition. A pilonidal cyst can easily be confused with a number of other conditions. A specialist is much less likely to make this mistake.

What Can I Expect at the Doctor’s Office?

Pilonidal cysts are diagnosed primarily through a physical examination. Your doctor will look at the area closely. In the case of a severely inflamed abscess, locating and diagnosing the cyst may only take a few moments. A blood test would confirm an increase in white blood cells, which indicates an infection. Most doctors, though, will forgo this testing when a cyst is seen during the exam.

How Is A Pilonidal Cyst Treated?

In many cases, a pilonidal cyst can be drained in the doctor’s office. This requires little more than numbing the area and making a small incision. Unfortunately, though, these cysts often return. If this happens, the doctor may recommend surgical removal.

If surgery is required, your doctor will explain the best options based on your individual case. You may be given local anesthetic or be offered IV sedation and general anesthesia. In addition, there are two types of ways to handle the surgical site after the cyst has been removed. These include:

  • Packing the wound. In this case, the wound is left open and packed with sterile dressing. This allows it to heal more gradually, reducing the risk of recurrence.
  • Close the wound. If your doctor chooses to close the wound, this will most likely be done with stitches. This will reduce the risk of infection and speed healing, but the risk of recurrence is much higher. Your colon and rectal surgeon will discuss the various types of closures and the advantages of each.

How Can I Prevent Recurrence?

After surgery, your doctor will make recommendations to help prevent another cyst from forming in the same area. This usually includes cleaning the area daily with antibacterial soap, rinsing it completely and keeping it dry. The recommendations may also include taking regular breaks during the workday, or finding other ways to reduce the amount of time spent sitting.

With expert treatment from your doctor, a pilonidal cyst should be healed in four to ten weeks. Cysts which require surgery or become severely infected will naturally take longer to heal. While these cysts do often recur, your doctor will offer tips to help prevent this from happening.

Los Angeles Colon and Rectal Surgical Associates

The surgeons of Los Angeles Colon and Rectal Surgical Associates are board certified and able to care for all diseases of the colon, rectum and anus.  If you have a pilonidal cyst, or any other problem, you can arrange to be seen by one of the surgeons, by calling (310)273-2310 for a confidential consultation.