Specialties

Pilonidal Cyst Treatment

What is a Pilonidal Cyst?

Pilonidal disease is the term used to describe chronic infection of the skin and soft tissue on the tailbone in the crease between the buttocks. It is more common in young men, becoming less common after age 40.  Persons with much hair in this region are at higher risk.  The cause of pilonidal disease is most likely due to ingrown hairs on the lower back.  The hair follicles on our skin become ingrown.  The skin becomes chronically irritated, and infection burrows down to the tailbone (sacrum and coccyx).  Painful abscesses can form, requiring surgical drainage or resulting in chronic draining sinuses and cysts.  The cycle repeats, and patients develop recurrent infections, chronic drainage, and pain.  While mild pilonidal disease can be treated with a course of antibiotic pills, most cases of pilonidal disease requires surgery to remove the chronic cysts, tracts, and abscesses and break the cycle.

Treatment Options

The key elements of surgery involve the patient being completely asleep and lying on their abdomen with their lower back and buttocks clipped, prepped, and draped sterilely. An incision is made over the skin of the tailbone.  All of the irritated, infected, and scarred in tissue is removed down to the tailbone. Sometimes if there is no evidence of infection, the wound can be closed in layers. Sometimes a drain is needed to help keep the wound closed. In instances of severe or recurrent disease or ongoing infection, the wound needs to be left open to allow it to slowly granulate and close in over time. The operation is usual straightforward and can be done on an outpatient basis.  Close follow-up with your surgeon after surgery is important to help give the best chance at cure.

Prevention Tips

Unfortunately, pilonidal disease can come back.  A key component to avoiding recurrence is keeping hairs free from the lower back and buttocks to minimize the chance of new infections.  It is helpful to have this area regularly trimmed or shaved, just as most men shave their beards and most women shave their legs. Hair clippers and nose-hair trimmers are helpful tools.  Some find it easier to use a hair-removing lotion (depilatory), as long as the area isn’t irritated.  Some use electrolysis or laser hair removal to keep hair away longer.

Surgery to help treat pilonidal disease can be performed by many of the surgeons of Central Carolina Surgery. If you have any questions or concerns, please contact us.