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Pilonidal Cyst




Pilonidal cysts is a small pit or sinus in the sacral area at the very top of the crease between the buttocks. Pilonidal cysts often cause discomfort. But the main concern is infection, which can result in a painful abscess. Treatment includes removing hair from the area and surgery to open and drain the cyst.

Considerations

The majority of pilonidal dimples are harmless, congenital anomalies that consist of a small depression or pit. There may be increased hairiness around the area.

The pilonidal dimple may also be a deep tract, rather than a shallow depression, leading to a sinus that may contain hair. These can become infected and drain. On rare occasions, the sinus may extend into the spinal cord.

During adolescence, the pilonidal dimple or tract may become infected, forming a cyst-like structure called a pilonidal cyst or tailbone disorders. These may require surgical drainage or total excision to prevent reinfection.

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Causes
    Congenital pilonidal dimple
    Congenital dermal sinus (of which the dimple is the mildest form)
Keep pilonidal dimples clean and free of debris during regular bathing. Report any drainage of fluid from the dimple, either clear or containing pus, to your health care provider.

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Complications

Infection is the main complication of a pilonidal cyst. An infected pilonidal cyst, referred to as a pilonidal abscess, is often very painful. A cyst that is painful, irritated or infected typically contains hair plus blood and clear or yellowish drainage that typically has a foul odor.

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Risk factors

Certain factors can make you more susceptible to developing pilonidal cysts. These include:
  • Male sex
  • Obesity
  • Inactive lifestyle
  • Occupation requiring sitting
  • Excess body hair
  • Poor hygiene
  • Excess sweating
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Treatment

First-time abscesses may need only simple incision and drainage. But if the cyst recurs or if there are multiple cysts or cavities, your doctor may recommend more extensive surgery. 

  • Incision and drainage procedure. During this procedure, you're given a local anesthetic to numb the area before your doctor opens and drains the cyst. Afterward, your doctor packs the wound so that it can heal from the inside out.
  • Surgery. Surgical treatment of recurrent pilonidal cysts usually involves opening and draining infected cysts and cutting away skin and flesh that cover any dimples or pits that could potentially develop into abscesses. The wounds are left open and packed to heal from the inside out. In some cases, the wound is partially sewn to prevent the wound from closing up prematurely. Surgery may be done with local, regional or general anesthesia.

Wound care treatment is extremely important after surgery for an infected cyst. Your doctor or nurse will give you detailed instructions on how to change the dressings. At home, you'll need to perform wet-to-dry dressings two to three times a day for several weeks. These dressings support a process called granulation, which helps to form new and healthy tissue from the inside out.

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Prevention

To prevent future pilonidal cysts from developing:

  • Remove any hair from this area on a regular basis. Shaving or depilatory creams work well, but you may need laser treatments for hair removal.
  • Clean the area daily with glycerin soap, which tends to be less irritating. Rinse the area thoroughly to remove any soapy residue. Washing briskly with a washcloth helps keep the area free of hair accumulation.
  • Keep the area clean and dry. Don't use powders, oils or herbal remedies on this area.
  • Avoid sitting for long periods of time.
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Information obtained from National Institute of Health
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