A Pilonidal Cyst is an abscess that occurs on the surface of the skin. It can also be considered a small pocket of debris. This debris is made up of skin and hair cells most often. Pilonidal cysts nearly always occur just at the bottom of the coccyx (the tailbone) or at the top of the cleft of the buttocks.
These pilonidal cysts can also become infected and fill with puss. When this happens, they may also be termed a pilonidal abscess although they are often still referred to as cysts in this state. The cause of a pilonidal cyst is often a hair growing back inward into the skin causing a great deal of irritation as the hair embeds into the skin.
Men are more prone to pilonidal cysts than women. However, anyone can get them. A person who works in a career field in which they sit for prolonged periods of time like drivers, office or call center employees, and the like may also be more likely to develop pilonidal cysts. When a person has developed a pilonidal cyst, they may be more likely to have the condition recur in the future as well.
A person with a pilonidal cyst may develop pain or swelling at the bottom of their tailbone. Redness in the area can also be a sign of this condition. A pimple-like growth occurs when the pilonidal cyst fills with pus and becomes infected. There may also be a visible hair that comes from the middle of the growth or lesion. Pilonidal cysts may drain pus, blood, or both and that discharge may have a foul odor as well.
There are two types of causes that contribute to the development of a pilonidal cyst. One type is congenital. Some children are born with a small crease near the upper buttocks that is called a sacral dimple. Often, this sacral dimple will become the focal point for the occurrence of a pilonidal cyst when the child reaches his or her early 20s.
A pilonidal cyst develops when hairs in the buttocks area work their way down into the skin. One way that the hairs are able to do this is when a person is seated for a long period of time, and the hair points are pushed up into the skin or an existing sacral dimple. The hairs may also work their way into the skin if there is prolonged friction in the tailbone area.
Once the hairs work into the skin surface, an infection develops. A cyst forms around the hairs filling with pus and debris.
If a pilonidal cyst is noticed before it fills with pus and becomes infected, the affected person may be able to just watch and wait to see if the cyst heals on its own. However, infected pilonidal cysts will likely need to be surgically opened (lanced or otherwise cut) and drained.
Depending on the circumstances, after the fact, the lesion may be packed with gauze and left open or it may be closed. If the doctor immediately closes the cyst, there is a higher chance of recurrence, but the wound packing and dressing will not need to be changed as frequently.
If a child is born with a sacral dimple, it is worth watching that area for the development of a pilonidal cyst as the child becomes older. Monitoring for hairs growing down into the area will prevent the development of a pilonidal cyst.
Diligent hygiene measures are important in preventing the development of an initial pilonidal cyst or preventing a recurrence. One should wash the area where pilonidal cysts occur daily with soap and water. This will clear out any loose hair or debris trying to work into the skin. Those who have a lot of hair in the area where cysts develop should consider shaving off the hairs as a preventative measure.
Those who are overweight should work to reduce their weight. Being obese produces greater friction in the area where pilonidal cysts develop.
Sitting for long periods of time, especially on hard surfaces, is a known pilonidal cyst risk factor. Those who sit for long periods should take breaks and get up and move about as much as possible.