Pilonidal Cyst (Not Infected)

A pilonidal cyst is a swelling that starts under the skin on the sacrum near the tailbone. It may look like a small dimple. It can fill with skin oils, hair, and dead skin cells, and it may stay small or grow larger. Because it often has an opening to the surface, it may become infected with normal skin bacteria.

Causes

The cause of pilonidal cysts has been debated since they were first recognized. It may be present at birth and go unnoticed. Injury, rubbing, or skin irritation may also cause pilonidal cysts. It can also be caused by an ingrown hair. Most likely, the cause is a combination of these things. Because some injury or irritation can lead to pilonidal cysts, it can be more common in people who sit or drive a lot for work.

Symptoms

A pilonidal cyst may be small and painless. If symptoms occur, they may include:

  • Swelling

  • Irritation or redness

  • Pain

  • Drainage

The cyst can swell and drain on its own. The swelling and drainage can come and go.

Treatment

If a pilonidal cyst isn't causing you any problems, you don't need any treatment. If it comes and goes, is bothering you, or becomes infected, you will need treatment. You may need surgery to fix it.

Home care

The following guidelines will help you care for your wound at home:

  • Keep the area of the cyst clean by bathing or showering every day.

  • Don't wear tight-fitting clothing over the cyst.

  • Don't try to squeeze the cyst or stick a needle in it to make it drain. It may feel better at first, but will make it worse and likely cause infection.

  • Watch for signs of infection listed below.

Follow-up care

Follow up with your healthcare provider, or as advised.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

  • Pus coming from the cyst

  • Increasing local pain, redness or swelling

  • Fever of 100.4°F (38.0°C) or higher (or 1 degree or higher above your normal temperature) for more than 2 days, or as directed by your healthcare provider

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