Pilonidal Cyst: Causes, Symptoms & Treatment for Pilonidal Cysts

Learn what can cause a Pilonidal Cyst, how to recognize it early, its symptoms, and effective treatment options!

Pilonidal Cyst

Pilonidal cyst is a common condition that, for many patients, remains a taboo even today. It is a particularly bothersome condition that causes embarrassment for the patient but poses no health risks.

What is a Pilonidal Cyst? A pilonidal cyst, or sacrococcygeal sinus, is a cyst located under the skin at the end of the spine in the intergluteal region, containing hair and skin debris. Its size can range from a small dimple to a large, painful mass. Essentially, hairs in the area become trapped under the skin and form a cyst, which can then become infected. The condition can be in a chronic or acute phase, requiring immediate treatment.

Pilonidal Cyst: Causes The exact cause of pilonidal cyst formation is not known. Although it was previously believed that pilonidal cysts were a congenital pathology, experts today believe that the condition is acquired and is due to hairs growing inwards, causing skin infection. A sedentary lifestyle, skin friction for various reasons such as tight clothing, can push hairs into the skin. Many factors have been identified that increase the likelihood of developing a pilonidal cyst, some of which are:

In some cases, it may appear without the presence of all the aforementioned factors.

Who is affected by Pilonidal Cysts? Pilonidal cysts affect individuals of all ages and both sexes, however, it appears to affect men more, which does not mean that it does not occur in women. According to epidemiological data, the condition affects 26 out of every 100,000 people internationally.

Risk Factors A pilonidal cyst can appear in anyone. However, some population groups have a higher probability, such as: Men, who appear to be 3 to 4 times more likely to develop a pilonidal cyst than women. Teenagers and individuals up to 40 years of age. Individuals in occupations that require prolonged sitting, such as truck drivers and office workers. Obese individuals, where the skin folds more easily. Individuals with abundant body hair and thick, coarse hairs.

Pilonidal Cyst: Initial Stage In its initial stage, a pilonidal cyst can be very small and asymptomatic, thus not perceived by the patient. They might feel a slight swelling or some discomfort, especially when sitting.

Pilonidal Cyst: Symptoms The symptoms of a pilonidal cyst range from mild, such as a small dimple in the area, to very severe. When the skin around the cyst becomes infected, it becomes painful, and one may experience: Pain Irritation and swelling of the skin Discharge of fluid from the cyst Foul odor from the draining pus. In more severe cases, a pilonidal cyst can even cause: Fever Nausea Weakness

Pilonidal Cyst: Diagnosis The diagnosis of a pilonidal cyst is made during a clinical examination. The doctor will ask about your symptoms, if the cyst has changed in appearance, if it is draining fluid, if you have had a fever at any point, and will evaluate the area. A visual examination is usually sufficient for the diagnosis of a pilonidal cyst. Blood tests or imaging studies are not necessary.

Pilonidal Cyst: Treatment After evaluating the condition, the severity of your symptoms, whether you have experienced a similar condition in the past, etc., your doctor will suggest the best treatment for your specific case. Treatment for a pilonidal cyst is personalized, and options are assessed taking into account the severity of the disease and the patients' lifestyle. The management of pilonidal cysts includes simple procedures performed in the doctor's office, as well as surgical removal. Depending on the characteristics of each case, treatment may include: Incision and drainage of the cyst, which relieves the patient in acute cases. The procedure is performed in the doctor's office under local anesthesia. Pharmacological treatment with antibiotics, which can treat inflammation but not the cyst itself. Chronic, complex cases are treated with surgery, which is performed using various methods. The surgeon specializing in colorectal procedures will explain which approach is appropriate for your specific case. Skin care is very important after any procedure. Depending on the surgical technique, the surgeon will provide instructions that must be followed until the wound heals.

Prevention By adopting simple habits in our daily lives, we can significantly reduce the incidence of pilonidal cysts. More specifically, by removing hair and keeping the area dry and clean, and by maintaining a healthy weight, you significantly limit the chances of a pilonidal cyst forming. Hair removal and keeping the area clean are essential in both acute and chronic forms of the disease, as they prevent the formation or recurrence of cysts. Alexandrite Laser hair removal at regular intervals determined by the doctor will prevent hairs from penetrating the skin, which can cause inflammation, while creating a clean environment that discourages microbial growth.

Bibliography https://fascrs.org/patients/diseases-and-conditions/a-z/pilonidal-disease https://www.ncbi.nlm.nih.gov/books/NBK557770/ https://www.toplinemd.com/advanced-surgical-physicians/blog/top-8-facts-about-pilonidal-disease/ https://www.pilonidal.org/what-is-pilonidal-disease/faq-diagnosing

Where does a pilonidal cyst appear?

A pilonidal cyst appears at the very end of the spine, in the so-called “tailbone” area.

How is a pilonidal cyst formed?

A pilonidal cyst is formed by hairs present in the area, which grow inward and become trapped in the skin, causing infection.

How should I sit when I have a pilonidal cyst?

By avoiding sitting on hard surfaces for long periods and generally limiting a sedentary lifestyle, you reduce the likelihood of developing a pilonidal cyst.

Can I tell if I have a pilonidal cyst?

Only a specialist doctor can confirm this for you, as symptoms vary among patients and also resemble symptoms of other conditions such as perianal fistula or perianal abscess.

Can a pilonidal cyst be malignant?

A pilonidal cyst is considered a benign condition. Very few cases, which had been left untreated for many years, have been reported as cancerous.

Is it safe to monitor the cyst instead of removing it?

Yes, in individuals without discomfort, regular monitoring is absolutely safe.

Is general anesthesia required for surgery?

In the vast majority of cases, procedures are performed with local anesthetic only.

Are there alternative (non-surgical) treatments?

Other treatments are offered, such as Laser cauterization or destruction of the cyst with solution injection, but there is insufficient data to evaluate their effectiveness, which is why at Facemed, we do not recommend them.

Is there a possibility of cyst recurrence after surgery?

Yes. If the predisposing factors do not change, there is always a risk of a cyst recurring.