Patient education: Pilonidal cyst (The Basics)

What is a pilonidal cyst? — 

This is a fluid-filled sac that forms just above the crease where the buttocks come together (figure 1). The cyst can become red, inflamed, and infected. It can also cause pain and make it uncomfortable to sit or lie back.

Pilonidal cysts are thought to be related to hair in the area.

What are the symptoms of a pilonidal cyst? — 

If the cyst is not infected, it might not cause symptoms. But if it is infected, it can cause pain, redness, and swelling in the area above the crease where the buttocks come together. An infected cyst is called an "abscess." In some cases, the cyst might burst and drain fluid, blood, or pus (a milky yellow or green fluid).

Should I see a doctor or nurse? — 

Yes. If you have symptoms of a pilonidal cyst, see a doctor or nurse. They can do an exam and figure out what might be causing your symptoms.

How is a pilonidal cyst treated? — 

If you have a pilonidal cyst without any symptoms, it probably does not need treatment. If the cyst is causing symptoms, treatment usually involves either draining the cyst or removing it with surgery:

●An infected pilonidal cyst (abscess) needs to be drained as soon as possible. This can be done in the emergency department or the doctor's office. To drain a cyst, a doctor or nurse will first numb the area. Then, they cut open the cyst, drain it, and wash it out. In some cases, they might also pack the empty cyst with gauze, or leave a drain in place. After the cut has healed, you should regularly remove hair from the area. You can do this by shaving carefully or using a hair removal product such as Nair. This might help prevent the pilonidal cyst from causing symptoms again.

●Removing a cyst involves surgery, so it is done in an operating room at the hospital. This is usually not an emergency, but a planned surgery. Right before surgery, you will get a shot to numb the area. You might also get medicine to make you drowsy. You can usually go home the same day. The wound might be closed or left open. You need to see your doctor regularly after surgery to check how the area is healing.

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