What is a pilonidal cyst?
A pilonidal (pronounced “py-luh-NY-dul”) cyst is a sac or pocket in the skin that is usually filled with fluid, hair, skin debris and other tissues. It almost always occurs near the tailbone (bottom of spine), above the cleft of the buttocks. The word pilonidal disease is usually used to describe people who have chronic pilonidal cysts that get infected. When infected, the cyst can become red, tender, swollen, and warm. This can cause severe pain and make it uncomfortable to sit or lie back.
How do pilonidal cysts form?
Doctors don’t know for sure how all pilonidal cysts are formed. However, it appears that most pilonidal cysts occur when a hair follicle becomes irritated or blocked. The hair in it then punctures the skin and curls back, gets trapped, and becomes embedded. Pressure and friction from tight fitting clothing, sitting for long periods etc, pushes the hair down into the skin. The immune system responds to the hair as a foreign body creating a cyst around it.
Who gets pilonidal cysts?
Anyone can get a pilonidal cyst. However, they are more common in people with the following risk factors:
Male
Younger (pilonidal cysts are more common in people who are in their 20s)
Trauma or irritation to the area.
Overweight/obesity
Sedentary lifestyle or inactive lifestyle
Jobs that require prolonged sitting e.g. truck drivers.
Deep natal cleft
Family history
Excess body hair
Stiff or coarse hair
How are pilonidal cysts treated?
Most pilonidal cysts will resolve with hair removal. However, your doctor may need to do surgery to drain any abscesses that may form. Surgical excision of all cysts or sinus tracts may be done to definitively treat chronic or recurrent disease. You should remove all hair from the area. You may use Nair to remove the hair or you can shave it or use a laser to keep the area free from hair. Sitting in a warm bath with Epson salt also provides relief.
When to call your doctor
If there is redness, swelling, significant pain, warmth, you should call your doctor as these are signs that an infection or abscess is forming.