Pilonidal Cyst FAQs: Answers Patients’ Most Common Pilonidal Cyst Questions

Pilonidal Cyst FAQs: Answers Patients’ Most Common Pilonidal Cyst Questions

If you have a pilonidal cyst, you probably have pain and discomfort. You probably also have pilonidal cyst questions.

Let's face it: This isn't the kind of thing that people usually discuss around the dinner table. It doesn't come up in everyday conversation. The silence around this topic can leave you uninformed about this condition and feeling in the dark about treatment options.

To shed some light on pilonidal cysts and how to deal with them, I've put together this fact sheet that will address some of your most pressing pilonidal cyst questions.

What Is a Pilonidal Cyst?

The cleft of the buttocks--the place where the two sides meet--is prone to developing cavities called pilonidal cystsin which hair, dead skin and other debris can accumulate.

Your pilonidal cyst may arise from a small depression in the skin that's been there since you were born. That's called a sacral dimple.

However, most people develop their cysts later in life for unrelated reasons. Some experts think that coarse hair around the buttocks penetrates the skin, and the body forms a cyst in response. Others believe that pilonidal cysts are the result of hair follicles that rupture.

Whatever their origin, cysts often become infected; infected cysts are called pilonidal abscesses. There can also be tracts leading from the cyst to the skin; they are called pilonidal sinuses.

Who Gets Pilonidal Cysts?

Although anyone can get pilonidal cysts, some people are more susceptible. Chief among them are young men, particularly those in their 20s. Women can get pilonidal cysts too, of course, but both men and women are most likely to get them before age 40.

There are additional factors that can increase the chances of developing pilonidal cysts. Carrying excess weight is one. So also is having excess hair on the buttocks or wearing tight clothing that rubs against the buttocks. People who are sedentary or have jobs that require a lot of sitting are more likely to get cysts.

What Are the Symptoms?

You may not notice an uninfected pilonidal cyst. Infection, however, can bring a whole host of symptoms:

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    Pain, especially when sitting.
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    Tenderness when the spot is touched.
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    Oozing blood or pus, possibly with a bad smell.

Left untreated, the infection may cause fever or nausea.

What Pilonidal Cyst Treatment Is Available?

Most doctors first treat an infected pilonidal cyst with an in-office procedure. After numbing your tailbone region, the doctor makes a small skin opening through which the cyst can be drained.

Unfortunately, draining is not usually a permanent fix. If your infection returns, the doctor may recommend surgical intervention. Pilonidal cyst surgery options include:


This is a procedure in which the complete cyst and some of the surrounding tissue are removed. After the surgery, the wound may be stitched shut or left open. In the video "Pilonidal Abscess: Excision and Primary Closure," you can see the process of removing the cyst and closing the wound.

In variations of this procedure, the cyst may be "unroofed." Only the top portion of the cyst and the tissues above it are removed. The lower portion remains in place, and the wound is left open to heal.


To treat your pilonidal cyst in a less-invasive manner, your doctor may suggest pit-picking. The cyst is removed through a small incision, and the surrounding tissue is left in place.

Recovery for this procedure is easier than excision recovery, but there's a higher chance that your condition will come back.

Laser Coagulation

A newer, very promising treatment for pilonidal cysts is done with lasers. After cleaning out the cyst, the laser is used to coagulate the abscess and any sinus tracts leading to it. The laser energy closes and seals these spaces without harming the surrounding tissue.

Lasers can also be used to finish off pit-picking. First, the cyst is taken out through a small opening. Then, the laser coagulates the tissue to seal it.

Will the Condition Come Back?

Unfortunately, pilonidal cysts can recur. The chance of recurrence varies with treatment methods. Among traditional surgeries, complete excision is often the best for limiting the chance of recurrence. Laser treatment is another promising method, and it presents an easier recovery period than excision.

No matter how your pilonidal cyst is treated, there are things that you can do to reduce your chances of developing another. First of all, follow your doctor's post-procedure directions, and attend all follow-up visits. After your wound has healed:

How can you avoid cysts? Remove excess hair and avoid sitting for long stretches.
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    Maintain a healthy weight.
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    Stay active. Avoid a sedentary lifestyle.
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    Keep the area clear of hair. Shave, use depilatories, or have laser hair removal.
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    Wash thoroughly and exfoliate regularly.
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    Wear loose, comfortable clothing.

Quick Review of the Basic Pilonidal Cyst Questions & Answers

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    What is a pilonidal cyst? It's a pocket in the skin near the end of the tailbone.
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    Who gets them? Young men get cysts more often than other groups.
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    What symptoms occur? Infected cysts may cause pain and redness.
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    How are they treated? Doctors can drain cysts or remove them surgically.
Brian Chandler

Brian Chandler