A pilonidal cyst is a small sac that forms under the skin, typically located near the tailbone in the crease of the buttocks. These cysts can contain hair and skin debris. While they are a common condition, affecting more than 70,000 people in the U.S. each year, they often do not cause problems unless they become infected.
Understanding Pilonidal Cysts
A pilonidal cyst is an unusual pocket in the skin, almost always found near the tailbone at the top of the buttocks. Experts believe these cysts form when loose hair and dead skin cells become trapped under the skin, often in the gluteal crease. Friction and pressure from activities like sitting or tight clothing can push hair into the skin, leading to the body forming a cyst around this foreign material. However, when they become infected, a person might experience pain, redness, and swelling in the affected area. Other common signs of an infected cyst include pus or blood draining from a small opening in the skin, which may have an unpleasant odor. A low-grade fever can also develop, indicating the presence of an infection.
When a Pilonidal Cyst Becomes Dangerous
A pilonidal cyst itself is rarely a fatal condition. However, complications can arise if an infected cyst is not managed promptly. The primary concern is the spread of infection.
An infected pilonidal cyst, also known as a pilonidal abscess, is a painful pocket of pus trapped beneath the skin. If this infection is left untreated, it can spread to the surrounding skin, leading to a condition called cellulitis.
A severe, untreated infection from a pilonidal cyst can potentially lead to systemic complications, such as sepsis. Sepsis is a life-threatening condition where the body’s response to an infection damages its own tissues and organs. While rare, if bacteria from the cyst enter the bloodstream and spread throughout the body, sepsis can occur and become life-threatening if not quickly managed. Chronic, recurring infections from pilonidal cysts have also been associated, in rare instances, with an increased risk of a type of skin cancer called squamous cell carcinoma.
Medical Attention and Treatment
Seek medical attention if you notice any signs of a pilonidal cyst, especially increasing pain, swelling, redness, drainage, or fever. A healthcare provider can diagnose a pilonidal cyst through a physical examination, looking for a dimple, bump, or drainage between the buttocks.
Treatment for an infected pilonidal cyst often involves draining the fluid and pus. This procedure, known as incision and drainage, can often be performed in-office under local anesthesia. A small cut allows the infected material to drain, and the wound may be packed with gauze to promote healing from the inside out.
Antibiotics may be prescribed if the infection has spread, but they cannot heal the cyst alone. For chronic or recurring cysts, surgical removal may be recommended.
Reducing Your Risk
Several measures can help reduce the risk of developing a pilonidal cyst or prevent its recurrence. Maintaining good hygiene, including regularly washing and thoroughly drying the area between the buttocks, helps remove bacteria, sweat, and debris that can contribute to cyst formation. Avoiding prolonged sitting is also recommended, as continuous pressure on the tailbone can increase risk; take breaks to stand and move around, or use a cushion to alleviate pressure. Hair removal strategies, such as shaving, creams, or laser removal, can reduce loose hairs that may become ingrown and lead to cysts. Wearing loose, breathable clothing, such as cotton, can minimize friction and irritation.