A pilonidal cyst is an abnormal sac in the skin that often contains hair and skin debris. It occurs at the bottom of the tailbone and can become infected and filled with pus. If a pilonidal cyst becomes infected, the abscess looks like a large pimple at the bottom of the tailbone and can cause pain and discomfort.

A pilonidal cyst is more common in men than in women and usually occurs in younger individuals, with chances for reoccurrence.

Treatment options typically involve a procedure that involves draining the cyst or surgical removal of the cyst.



Once infected, the technical term for a pilonidal cyst is pilonidal abscess (swollen mass). Signs and symptoms of an infected pilonidal cyst include:

·         Pain/discomfort when sitting or standing

·         Swelling of the cyst

·         Reddening of the skin

·         Draining pus

·         Foul smell from draining pus

·         Temperature



Though the exact origin of pilonidal cysts remains unknown, they appear to be caused by a combination of factors such as:

  • Loose hairs that penetrate the skin
  • Friction (such as from prolonged periods of sitting or riding a bicycle)
  • Changing hormones


Pilonidal means “nest of hair”. When there is a rupture of a hair follicle (the structure from which a hair grows), the formation of a cyst appears around the ruptured follicle.

Risk factors

Individuals who sit for prolonged periods of time such as truck drivers are at a higher risk of developing a pilonidal cyst. Other factors that can increase the risk of developing pilonidal cysts include the following:

·         Being overweight

·         Being physically inactive

·         Having excess body hair

·         Having poor hygiene



If an infected pilonidal cyst isn’t treated properly, a particular complication that can arise is the development of a type of skin cancer called squamous cell carcinoma.


The two main treatment options for an infected pilonidal cyst are:

  • Marsupialization: a procedure that involves incision, draining of the cyst (removal of pus and hair) and sewing of the edges of the fibrous tract to the wound edges to make a pouch. This allows for the wound to heal from the inside out and lower the risk of reoccurrence.
  • Surgical removal of the cyst: a procedure that involves undergoing surgery to remove the cyst and proceed to immediate closing of the wound with stitches. This procedure allows for faster healing, however, it increases the chances for recurrence (removal of the entire cyst may be difficult)

No matter the option, wound care is extremely vital after surgery. The key steps to recovery involve: Washing around the area once a day, changing dressings and shaving around the surgical site.  It is important that an individual follow these particular steps in order to prevent hairs from entering the area, further infection or reoccurrence.  




A few recommendations to help prevent the developing of pilonidal cysts include:

·         Keeping the affected area clean

·         Avoiding prolonged sitting

·         Exercising regularly

·         Losing weight if necessary

·         Shaving areas where there is excess hair growth, in order to reduce the chance of pilonidal cyst occurrence