A pilonidal cyst is a painful condition that plagues many patients. The term refers to an inner skin infection (abscess) that occurs on the natal cleft of the buttocks. Because the pain can intense and the cyst may cause deformity, it is important to find the most effective treatment plan and the best doctors.

Symptoms and Causes

The first symptom is typically pain. Usually, in the early stages of the cyst the pain is mild. Because of this, patients often do not seek quick treatment. The skin at the surface of the cleft will begin to swell, becoming very red or even white. The cysts vary in size. Generally the larger the size, the worse the symptoms become. The pain may even become debilitating, requiring emergency care.

There are competing theories as to the source of the infection. Many believe that it is due to impaction of hair beneath the skin at the gluteal cleft. This can be from a high frequency of sitting caused by inactivity or having a desk job that requires sitting for long periods. The hair can be forced into the skin and after time become infected.

This condition was extremely common during World War II, with over 70,000 soldiers reported having pilonidal cysts.


Even though these cysts are an infection, antibiotics are not often effective for treating pilonidal abscesses. The primary choice of treatment during an acute infection is to drain the infection. This is done with local anesthetic to numb the area. Your surgeon will then drain the pus inside the cyst. This is the first step, however this is not a curative step. For a cure, a second surgery is done to address the cyst cavity itself and remove it from the body.

There are several methods for cyst treatment. They range from excision to open wound techniques. The difficulty with closed techniques is that the tension on the wound in that area places it at very high risk of wound breakdown.  Because of this, many surgeons these days resort to open wound techniques.

One way of addressing the tension on the wound is to utilize tissue flaps. Flaps are challenging however, and if done improperly, can lead to an even larger problem. Since few utilize them, most surgeons have little to know experience in the use of these flaps.  Our surgeons have been trained in the use of flaps and have successfully used them to treat patients with pilonidal disease.

Contact Colorectal Experts Today

If you would like to know more about pilonidal cyst removal and the treatment plan that works best for you, contact the surgical experts at La Peer Health Systems today. For a consultation, call 888-397-7135 or fill out our contact form.

Next read about Preventing Cysts and Abscesses.