Pilonidal Cyst: Antibiotics as a Treatment?

Pilonidal Cyst: Antibiotics as a Treatment?

Pilonidal Cyst

You're pretty sure you have a pilonidal cyst. You're heading to the doctor for confirmation of your suspicions, but what can you expect from your appointment? Will the doctor prescribe antibiotics?

Don't count on it. While antibiotics are sometimes used for the treatment of pilonidal disease, they're not a primary method of resolving this condition. Ahead, you can learn why pilonidal cyst antibiotics aren't very common and discover what may be done instead.

What Antibiotics Can Do for a Pilonidal Cyst

Antibiotics are used to treat bacterial infections. When a pilonidal sinus becomes infected, bacteria build up in the cavity. Therefore, taking antibiotics may help clear up the problem if the infection isn't far along.

If the skin and tissue surrounding the pilonidal sinus becomes infected as well, the condition is called cellulitis. Symptoms include redness and swelling. A one- or two-week course of oral antibiotics can be necessary for treating this serious condition.

You can learn more about cellulitis in the following video:

What Antibiotics Cannot Do for a Pilonidal Cyst

As a pilonidal abscess becomes larger and more serious, the pocket of infection becomes filled with more and more pus and other debris. Antibiotic treatment can't reach the infection that's in the center of that mess, so trying to treat the problem with medication alone would be a losing battle.

Whether or not antibiotics manage to clear up the infection in a pilonidal abscess, they can't heal the unnatural dimple or channel that's present in the skin. The pilonidal structure will remain and be quite prone to reinfection.

More Effective Approaches to Treating Pilonidal Disease

Instead of prescribing antibiotics for your pilonidal abscess, your doctor is likely to recommend other treatments.

Pilonidal Sinus Drainage

An in-office drainage procedure may be the first step. The doctor will make an incision so that the pus and other fluid inside the pilonidal sinus can flow out. After that, the doctor will use surgical tools to clean any debris out of the cavity.

Although there is recovery time involved with this procedure, it is usually much more effective than antibiotics at fully addressing the infection in a pilonidal sinus. Because the pus and buildup will no longer be straining against the surrounding tissue, you may feel immediate relief.

Pilonidal Sinus Surgery

If you experience recurrent pilonidal infections, it's unlikely that your doctor will continue to prescribe antibiotics again and again. Using medication once may be worth a try, but repeatedly relying on that approach is simply ignoring the larger problem.

Instead, you may need surgery. There are a number of surgical approaches to treating pilonidal sinuses. These include full excisions in which the complete sinus tract, cavity and surrounding tissue are removed from the body, and pit-picking, in which the doctor makes only a small incision and removes as little material as possible.

Laser ablation is another approach to pilonidal cyst surgery. In this procedure, the goal is to close up the sinus tract so that it can no longer trap debris and get infected.

First, the sinus and cavity are thoroughly drained and cleaned. Then, a neoV Laser probe is inserted into the opening. The light energy from the laser ablates the tract so that it sealed shut.

Sometimes, laser ablation is performed as a solitary procedure. Other times, it is done as an accompaniment to pit-picking. Following a pit-picking procedure with laser treatment can help increase the effectiveness compared to pit-picking alone.

Antibiotics and Pilonidal Cyst Surgery

Once it's been determined that you're going to need surgery for your pilonidal disease, your doctor's attitude toward antibiotics may change a bit. There's a possibility that you'll be prescribed antibiotics as a pre- or post-surgical treatment. Some doctors do this to reduce the likelihood of patients developing a follow-up infection during the recovery period.

However, experts debate the validity of this practice. Some research indicates that antibiotics don't significantly improve outcomes. Those findings apply to intravenous, oral and topical medications.

Because pre- or post-operative antibiotics haven't been proven very effective, there's a good chance that you won't be prescribed any unless there are extenuating circumstances. For example, you'll probably need antibiotics to address a cellulitis infection. You may also need medication if you have a compromised immune system or other serious health issues.

Other Ideas for Preventing Post-surgical Recurrences

If antibiotics aren't the answer to preventing a recurrence, what can you do instead? Keep the surgical site clean and dry. Do what you can to reduce pressure and friction in the area; tips for this include maintaining a healthy weight, wearing loose-fitting clothing and staying active instead of sitting for long stretches.

Removing hair from the area can help as well. The easiest and cheapest methods for this are shaving and using depilatory creams. For a more permanent option, consider laser hair removal.

Above all else, listen to your doctor's advice for preventing a recurrence. If your colorectal specialist suggests that post-operative antibiotics might be worthwhile in your case, then it's smart to heed that advice.

But as a general rule, don't expect antibiotics to be your doctor's go-to approach for resolving an infected pilonidal sinus. Medications are used only in select instances.

Instead of pilonidal cyst antibiotics, your treatment plan is likely to include drainage or surgery, such as laser coagulation with the neoV Laser. After your treatment, lifestyle management and hair removal may be more effective than antibiotics at keeping recurrences from happening.

As with all medical issues, your physician is the ultimate source as to what procedure best fits your needs. Discuss all options and get a second opinion if you have any doubts. These articles are intended to be a source of general information only.


Jen O'Keefe