A Patient's Guide to Pilonidal Cysts: What You Need to Know

A Patient’s Guide to Pilonidal Cysts: What You Need to Know

Your doctor has diagnosed you with a pilonidal cyst. If you've been noticing uncomfortable symptoms, this may not come as a surprise to you. However, you might be wondering what exactly this condition is and how it will be treated.

Pilonidal Cyst Facts

Pilonidal cysts are small, abnormal sacs of hair and skin cells that form at the top of the buttocks where the two sides meet.


Babies are sometimes born with a skin dimple at the top of the buttocks. This can become infected and form a cyst.

After early childhood, outside influences cause cysts to develop. The problem is often related to hairs in the area. The roots of these hairs become inflamed, perhaps because of the pressure caused by frequent sitting or excessive weight. A fistula tract develops and expands into the fat that is under the skin.


Cysts are more common in males than females. They most often occur in young people, particularly those in their 20s.


Infected pilonidal cysts can cause unpleasant symptoms. These may include:

  • Pain
  • Redness
  • Soreness to the touch.
  • Discomfort with everyday activities, such as sitting, standing or walking.
  • Oozing of blood or pus.

A doctor can diagnose a pilonidal cyst by looking at the affected area and discussing the symptoms with you.

Pilonidal Cyst Treatment

A doctor will usually first treat pilonidal cysts by numbing and draining the area. If this treatment does not clear up the problem or infections keep recurring, surgery will be required.


Traditional surgery for pilonidal cysts involves cutting out the affected area--both the cyst and the surrounding tissue. The excision may go down as far as the connective tissue that surrounds the tailbone.


This alternative treatment is a minimally-invasive procedure in which only the fistula orifice is removed from the body. The cavity is cleaned out to drain infection and remove trapped hairs. The incisions made during a pit-picking procedure are much smaller than those in traditional excision.

Laser Treatment

Pit-picking alone can be a successful method of eliminating a cyst, but when the cyst is coupled with a significant fistula tract, the greatest success comes from pairing the procedure with laser treatment.

A specialty laser is inserted into the fistula channel. Its corona of light ablates the fistula and destroys remaining hairs that are trapped inside. The procedure preserves the surrounding tissue.

Treatment Recovery and Outcomes

The recovery timeframe depends on the procedures used to treat the cyst. Traditional removal surgery results in a long hospital stay. Recovery time can be slow. The skin in this area of the body is quite taut, and that hinders the healing process.

Pit-picking, however, usually has a shorter recovery time because the wounds made at the incision site are minimally invasive. Laser treatment, too, requires less healing time than traditional excision.

The pit-picking procedure alone has an 80-percent success rate. When paired with laser treatment, the success rate jumps to 92 percent.

After treatment, it is usually recommended to have a medical hair-removal procedure in the area. This can help prevent recurrence. Keeping the area clean can also help avert new pilonidal cysts.

Brian Chandler

Brian Chandler