Treatment usually requires having a pilonidal cyst removed surgically.
While a cystectomy, or cyst removal, is usually effective, there is a high rate of recurrence.
What Is a Pilonidal Cyst?
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Pilonidal cysts develop near the crease between the buttocks, known as the intergluteal cleft.
The abscess fills with foul-smelling pus.
The pain of an infected pilonidal cyst is often excruciating.
However, women can get pilonidal cysts as well.
Ultrasound also may be used to determine the scope of the infection.
In fact, it will likely only be considered if other treatments have not worked.
The typical first-line treatment is to lance the boil.
This can be done in your healthcare provider’s office or emergency room using local anesthesia.
The next level of treatment is incision and drainage.
Possible Risks
Pilonidal cyst surgery is a generally safe procedure.
Your healthcare provider will discuss the benefits and risks with you before surgery.
What to Wear
you should wear something comfortable that is easy to change out of.
You will be in a hospital gown for the procedure.
Do not wear any jewelry, and leave anything of value at home.
Certain drugs can interfere with medical procedures and should not be taken prior to any surgery.
In particular, blood thinners may cause problems with blood clotting during surgery.
Don’t assume that your entire surgical team knows what medications you are taking.
The procedure itself should take about 45 minutes.
The anesthesiologist will connect you to an IV to give you medicine to relax.
If you are havinggeneral anesthesia, you will be asleep for the procedure.
The area will be suctioned to remove pus and cleaned with saline.
Depending on how much tissue was excavated, the wound may be left open to keep watch for infection.
If a lot of tissue has been removed, the wound may be packed with gauze.
In addition, a drainage tube may be left in to help fluid continue to drain and prevent reinfection.
If the wound is large, your healthcare provider may need to close it up with stitches.
In some cases, skin flaps may need to be created so that kill the wound.
There is a greater risk of recurring infection if the wound is closed after surgery.
Recovery
The timeline for healing after pilonidal cyst surgery varies based on how the surgery was performed.
Most people can return to work in two to four weeks after surgery.
However, it is advised to avoid strenuous exercise and activity until the area is completely healed.
You will likely need several follow-up appointments.
Do not drive the first 24 hours after surgery and while you are taking narcotic medication.
The timeline for this varies depending on your individual circumstances.
Recurrence
Unfortunately, pilonidal cysts can return after surgery.
Between 13.8% and 32% of pilonidal cysts recur within five years of pilonidal cyst surgery.
Healing
The first few days after pilonidal cyst surgery can be uncomfortable.
Since the wound is by your tailbone, it may be difficult to sit or find a comfortable position.
Sitting on a soft pillow or donut seat may bring relief.
Over-the-counter pain relievers like Tylenol (acetaminophen) should help ease the discomfort.
If not, your healthcare provider may prescribe pain medicine to take on a short-term basis.
It is very important to keep the wound clean and dry until the skin is fully healed.
Pat the area dry after showers, but avoid taking baths until the wound is healed over.
If you prefer a more permanent solution,laser hair removalor electrolysis may be a better option.
A small study of 60 patients found post-surgical laser hair removal significantly reduces the risk of recurring pilonidal disease.
Further research has shown that laser treatments to control hair growth are more effective than repeated surgical treatments.
Concentrating on correct posture when sitting can also help you manage the pain.
Possible Future Surgeries
Pilonidal sinus disease can be a chronic, recurring condition.
Summary
Pilonidal cysts are painful cysts near the tailbone that easily become infected.
Left untreated, they can turn into an abscess (a swollen pocket of infection).
You may need pilonidal cyst surgery to prevent these complications.
Keep in mind that the cyst can return after surgery.
Weigh the pros and cons of treatment with your healthcare provider.
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2012;97(3):224229. doi:10.9738/CC86.1
American College of Surgeons.Medication and surgery: before your operation.
Michigan Medicine, University of Michigan.Pilonidal cyst.
The Oregon Clinic.Discharge instructions for after pilonidal cystectomy.
MyHealth Government of Alberta.Pilonidal cyst removal: what to expect at home.
2016;31(5):857-862. doi:10.1007/s10103-016-1920-0
Pilonidal Support Alliance.Living With Pilonidal Disease.
