What Are the Treatments for a Pilonidal Cyst?

A pilonidal cyst is a small pouch or sac in the skin that commonly forms on the tailbone at the top of the buttocks. These cysts can fill with debris such as dead hair which pushes through the skin, creating a sinus cavity that can easily become infected. In most cases, pilonidal cysts can be treated effectively with cleaning and sterilization, or by draining any areas of infection. Some people who experience recurring infections, however, may require surgery.

A man in a bib and brace outfit holds his lower back with both hands as if in pain. (Image: Catalin205/iStock/Getty Images)

Medication and Cleansing

To prevent and treat infection of pilonidal cysts, doctors may prescribe antibiotics, according to CIGNA health. Patients may also treat the cyst by cleaning it regularly with a mixture of antibacterial soap and water or by taking a soothing, medicated bath. Patients with painful, infected sores may also be advised to take over-the-counter nonsteroidal anti-inflammatory medications like acetaminophen or ibuprofen to help ease the pain, according to the University of Michigan Health System.

Drainage

When pilonidal cysts become infected, they turn into pus- or fluid-filled abscesses. The first line of treatment for an infected pilonidal cyst is typically to drain this fluid from the wound. After numbing the cyst with a local anesthetic, a doctor uses an instrument to open the sore, extract the pus and sterilize the abscess by removing dirt, hair and debris from the wound and surrounding skin. To keep the cyst protected from further infection and to promote healing, the physician usually packs the open wound with sterile gauze. According to MayoClinic.com, up to 60 percent of all patients with infected pilonidal cysts require no additional treatment after such drainage.

Surgery

Patients with pilonidal cysts that repeatedly become infected may require surgery. According to FamilyDoctor.org, there are two common surgical approaches used to treat these infections. In the first approach, a surgeon makes an incision into or right next to the cyst and cleans the abscess and infected sinus pocket beneath the skin. He then closes the wound with stitches. In the second approach, the physician makes an incision into the cyst, drains and cleans it, covers it with gauze, then leaves it open to heal. The Mayo Clinic notes that, compared with the closed-wound surgical procedure, this approach poses less risk of recurring infection; however, healing generally takes significantly longer and the sterile dressings require regular changing to keep the area clean.

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