A Pilonidal cyst is small cyst formed at the top of your buttocks when dirt, hair and other debris get stuck there. The small dimple-like skin tunnel on the top of your buttocks is called Pilonidal sinus. This can sometimes get filled with fluid or pus and form a painful swelling like a cyst or an abscess. The cyst is generally filled with dirt, hair and debris. It is not a serious, life threatening condition. However, it might get infected and cause severe pain and swelling, which could make it difficult to perform even the simplest tasks like sitting or even standing. If it gets infected, it may ooze pus and blood and have a foul smelling odour.

Pilonidal Cyst: Things You Need to Know

Causes

This is primarily a skin condition and can be caused by many factors. Its exact cause isn’t known, but it can be caused due to various factors such as thick body hair, friction from clothes, improper cleaning of the area which leads to dust accumulation, and from spending a long time sitting down. In fact, this condition is more common in those who spend a majority of their day sitting, such as cab drivers. Some people are born with a deeper pilonidal sinus than others, which makes them more susceptible to developing a pilonidal cyst.

Thickness of body hair is also a factor because men are twice more likely than women to have this condition. Activities than cause friction, such as sitting, can cause the hair growing in the area to be forced inwards, and it can get stuck in the pilonidal sinus, leading to formation of a pilonidal cyst. The cyst is formed because the body does not recognize this hair and thinks of it as a foreign object, launching its immune response, which is to create a cyst around it. This is similar to how the body deals with splinters.

Some experts believe that it is formed due to trauma to the area, which can cause hair in the area to be ingrown, thus leading to the cyst formation. Local shaving in the area can also cause hair to be ingrown, which might cause pilonidal cysts or abscesses. If someone is overweight or obese, their pilonidal sinus gets deeper, and it becomes more likely for hair, dead skin, dirt and debris to get caught there, thus making them more likely to have this cyst.

Symptoms

The symptoms of this aren’t very noticeable at first. At first you might not even notice much except for a small dimple like depression at the cleft of your buttocks. Once this gets infected, however, you will experience sharp pain in the area, which will get aggravated if you perform something that causes friction in the area. This pain is the result of the cyst filling with fluid or pus. Sometimes, instead of a cyst, an abscess can form. These are some things you will experience if there is a pilonidal cyst forming in your body:

• Reddened, raw, sore and/or sensitive skin around the area.
• Swelling of the cysts and the area around the cyst.
• If the cyst is caused due to accumulation of hair, you might notice hair protruding from the lesion.
• Pus or blood draining from the abscess and causing a foul odour.
• Formation of more than one sinus tracts or holes in the skin.
• Pain while performing activities which involve using the area, for example, sitting or standing.
• Sometimes you might even run a fever of low intensity, but that isn’t very common.
• If your cyst gets severely infected, then there is a chance that you will experience extreme lower back pain whose focal point is at the cleft of your buttocks.

Diagnosis

Diagnosing a pilonidal cyst involves a thorough physical examination. The cyst is typically a lump or a boil located at the top of your buttocks, and it can sometimes be draining blood or pus. The location of the cyst at the top of your buttocks makes it characteristically a pilonidal cyst.

If the infection is severe, your doctor might ask you to get a blood test done. Imaging tests aren’t required to diagnose a pilonidal cyst.

Treatment

There are a few home treatments you can do, to relieve pain and swelling. Once that is gone, the cyst normally goes away on its own in a while.

• Sit in a bath filled with warm water up to your waist. Soaking in warm water helps to relax your sore muscles and relives pain. You can add a little Epsom salt to your bath; Epsom salt is very effective in pain relief.
• Apply essential oils such as tea tree oil and sage oil. These natural oils will help soothe the pain in the area. Additionally, tea-tree oil is a natural disinfectant which may even fight the infection.
• You can find products in the market such as ointments and powders which help prevent ingrown hairs. Applying such products regularly can help prevent the formation of such a cyst.
• You can use a cushion to support your buttocks while sitting. Use cushions especially when you’re sitting on hard surfaces for long periods of time.
• Exercise regularly. This improves blood flow. This will benefit you in two ways: prevent ingrown hair and aid quick healing.

Sometimes, if home remedies do not work and your cyst is very severely infected, you should go to a doctor. There are a number of ways in which your doctor might opt to treat you:

• Treatment for pilonidal cysts means draining the infection (abscess), usually by lancing open the cyst and cleaning the infected area. A procedure called an “incision and drainage” (I&D) is performed either using local anesthesia or general anesthesia; this process drains pus and debris from inside the cyst cavity. Pit picking is a non-excision procedure that involves a lateral (side to side) incision that drains the cyst, and the midline pits leading under the skin are removed.
• If your cyst is diagnosed early and you aren’t experiencing severe pain, and there’s no sign of inflammation, your doctor will most probably prescribe an antibiotic. A broad-spectrum antibiotic is an antibiotic that treats a wide range of bacteria. It’s important to realize that this won’t heal the sinus tract, but it will give you relief from the infection and discomfort. Your doctor will recommend that you get a follow-up exam, regularly remove hair or shave the site, and pay particular attention to hygiene.
• Sometimes your doctor might prescribe getting a phenol injection. Your doctor will first administer a local anesthetic on you and then inject phenol, a chemical antiseptic into the wound. This will harden the area and eventually close it. However, this treatment has a high recurrence rate.
• If you are suffering from an autoimmune disease, then you might need to go in for a surgery and hospitalization might be necessary.

A pilonidal cyst can be prevented by keeping the area clean and hair free, and keeping it dry. Maintain proper hygiene. Exercising regularly is another way you can prevent a pilonidal cyst from forming. If you are overweight or obese, you are more susceptible to getting this. Try and lose weight. Maintain a good and straight posture to prevent friction in between your buttocks so that you don’t get a pilonidal cyst forming. If your cyst is still recurring, you must contact your personal physician.

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