What causes a pilonidal cyst or sinus?
Hairs puncture the skin to initiate formation of a cyst. This occurs from the natural rolling movement of the buttocks and is worsened by the pressure of sitting, friction of walking and the accumulation of sweat. Initially, the cyst or sinus may be painless. It can become inflamed, swollen, painful, and discharge pus or blood (an abscess). The individual may generally feel unwell or, less commonly, develop a fever.

How is a pilonidal abscess treated?
Treatment depends on the severity of the symptoms. Antibiotics have not been shown to be effective in treating this condition. An incision and drainage may be necessary, or a clinician may suggest surgery to completely remove the infected cyst. After the cyst is drained or removed, it may be necessary to have regular dressing changes to allow the wound to heal properly and prevent infection. Regular follow-up visits will be necessary to assess the healing progress of the wound.

To promote healing the following is advised:

• Shower or use warm water to wash the area. Baths can be soothing. Be sure the wound is clean and dried thoroughly.
• Do not use disinfectants or antiseptics, as they can sting and will impede healing.
• After using the toilet, avoid the wound when wiping the anal area.
• Wear cotton underwear and loose-fitting clothing.
• Eat a healthy and balanced diet. Good nutrition is essential for healing.

How can pilonidal cysts be prevented?

• Thoroughly wash between the buttocks when showering.
• Consider careful removal of hair from the area by shaving or using chemical hair-removal products. This treatment alone may resolve cases with mild symptoms.

When should a clinician be consulted?
Consult a clinician if any of the following is experienced:

• Uncontrollable pain
• Fever
• Pain or drainage that returns after the wound has healed

To make an appointment with a doctor from Colorectal Physicians & Surgeons of PA, please call 814-453- 2777.