A pilonidal cyst is a small hole found at the top of the cleft in the buttocks near the tailbone. It forms when hair or other debris makes a small puncture in the skin and becomes embedded. While it starts out as a small problem, the cyst will grow over time as hair, lint and other matter can become trapped.
If the pilonidal cyst becomes infected, an abscess forms. An abscess is a pocket of pus that can be extremely painful and needs to be drained by a healthcare professional in order to obtain relief. Antibiotics may also be prescribed.
The trouble with a pilonidal cyst is that once it forms, it doesn’t go away on its own. It may lie dormant for long stretches and not bother you, but when it flares up in an infection, sitting can be nearly impossible and the pain is constant. Surgical removal of the cyst is the only course of treatment in this case.
Pilonidal cysts most commonly occur in men, but women can also suffer from them.
The surgeon excises the cyst itself and some surrounding tissue to ensure that no small openings in the skin are left for hair to become caught in again. In order to reduce the risk of the pilonidal cyst recurring, the post-op wound care is important.
There are two approaches to the healing process: leaving the wound open or suturing it shut.
When a pilonidal cystectomy is performed on a cyst with an active infection, the surgeon will likely elect to leave the wound open. You’ll be sent home with a few weeks’ worth of gauze and other wound dressing materials. The wound will have to be packed with a clean dressing a couple of times a day at first, reducing to once or twice a day as the skin slowly heals. This method of healing takes a little longer but it does help reduce the recurrence of pilonidal cysts.
If the cyst is not inflamed or infected, primary closure is a possibility. The surgeon may choose to simply sew the excision shut. In this case, healing will be much quicker and packing of the wound won’t be necessary. Your surgeon will be able to tell you the best course of treatment for you.