Pilonidal cysts are fluid-filled sacs or abscesses that form at the base of the tailbone, typically forming a pimple-like protrusion that can be quite painful. Pilonidal cysts can develop at any age, and they’re more common among men and among those who spend long periods of time sitting. Cysts often form when a hair becomes “ingrown” or embedded beneath the skin, causing inflammation and infection. The cyst itself forms around the hair as part of the body’s natural reaction to a foreign substance. Pilonidal cysts are more common among men and among those who spend long periods of time sitting. Having very coarse or stiff hair and being obese can also increase the likelihood of developing a cyst.
In addition to pain, pilonidal cysts can cause redness and tenderness in the skin, sometimes accompanied by a drainage of pus or blood. Symptoms are worse when sitting or applying pressure to the area.
Treatment depends on the size and “stage” of the cyst. Very mild cysts may be treated by soaking in a warm tub to relieve inflammation. More advanced cysts may require drainage to allow the area to heal. During drainage, a local anesthetic is injected near the cyst and a tiny incision is made into the cyst to enable the trapped fluids to drain out. Infected hair follicles are also removed during the procedure. Once the procedure is complete, the site is packed with sterile gauze to keep the area clean. Healing takes about three weeks, and frequent gauze changes will be necessary to keep the area free of germs and debris while it heals. Some cysts are treated using a technique called marsupialization which sutures the edges of the incision together, avoiding the need for gauze packing. Healing takes about six weeks. The approach used will depend on several factors, including the location of the cyst.