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The inflammation from a pilonidal cyst can be treated at home but the cyst will not go away. The tract that's formed and that's causing the problem won't heal up without help. There will be the potential for it to become infected again. The size of the incision and how much of the skin and tissue is removed will vary depending on the type of procedure. In some cases, if the surgery is more extensive, there could be a need for general anesthesia and being hospitalized. A pilonidal cyst is usually diagnosed by examining the area of the natal cleft for a cyst.
How can I prevent pilonidal cysts?
If the cyst does not heal after draining or you continue to have problems, a pilonidal cyst surgery may be needed to surgically remove the cyst and surrounding tissue. Lancing may work to remove the initial infection, but pilonidal cysts can be complex, and they frequently return and worsen over time. Pilonidal surgery is a minor procedure typically performed by a colorectal surgeon who removes the cyst and any surrounding infection. While a cystectomy, or cyst removal, is usually effective, there is a high rate of recurrence.
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The physical examination for suspected pilonidal disease should involve an anal examination to rule out fistula. The causes of pilonidal sinus disease are not well understood but may have to do with ingrown hair or hair that finds its way under the skin, causing a cyst to form. Other factors may contribute to the problem, such as prolonged sitting, having obesity, and having coarse hair. Keep in mind, though, pilonidal cysts can become chronic when those that do not drain on their own are left untreated.
Recurrence
Various types of cancer have been diagnosed as or in conjunction with pilonidal disease. A medical professional will typically treat all forms of pilonidal disease, including pilonidal cysts, through surgery. Pilonidal sinus disease can be a chronic, recurring condition.
Pilonidal cysts can be a one-time (acute) problem or you may have chronic (returning) cysts. If they’re not treated, chronic pilonidal cysts can also lead to abscesses (swollen pockets of infection) and sinus cavities (empty spaces underneath the skin). Following treatment, it’s crucial to adhere to your healthcare provider’s post-operative instructions. This may include wound care, keeping the area clean, and avoiding activities that could irritate the surgical site. Regular follow-up appointments with your healthcare provider are essential to monitor the healing process and address any concerns promptly. Typically one to four treatments of hair removal, cyst curettage, and phenol application into the cyst and tracts can result in complete resolution of the condition.
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However, the exact type of surgical technique that’s most effective is still being debated. For this type of treatment, your doctor will first give you a local anesthetic. They will then inject phenol, a chemical compound used as an antiseptic, into the cyst.
Surgical pilonidal cyst removal
A pilonidal cyst is a round sac of tissue that's filled with air or fluid. This common type of cyst is located in the crease of the buttocks and is usually caused by a skin infection. Pilonidal cysts are a common condition, with more than 70,000 cases reported in the U.S. every year. But many people feel too embarrassed to mention it — even to their healthcare providers. Whether it is an initial or recurring occurence, first-line treatment of acute pilonidal disease with abscess is incision and drainage. This option is successful in 60% of patients with primary disease, with 40% requiring an additional procedure.
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. Maintaining good hygiene around the area at the base of the spine is important. This helps prevent the development of pilonidal disease, as well as its recurrence if it does occur. Standard excision methods typically remove the affected sinus but do not pull skin folds over the wound area for healing.
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A pilonidal cyst is almost always near the tailbone at the top of the buttocks. Once everything has been removed from the cyst, they’ll pack the wound with sterile gauze or close it with stitches, depending on the location. Make sure to follow the wound care instructions from your doctor as you recover. The only way to get rid of a pilonidal cyst is through a minor surgical procedure.
Friction and pressure from rubbed skin, tight clothing, cycling or long periods of sitting can force hair into the skin. • Abscesses should be treated with incision and drainage or surgical excision. Once you’ve had a pilonidal cyst surgically drained, there are several things you can do to reduce your risk of developing another one. Sometimes, a pilonidal cyst will reappear in the same area, even if you recently had one drained. When this happens, you may need a more extensive surgical procedure to remove the entire cyst, not just the internal contents. You can get a pilonidal cyst when a hair gets lodged inside your skin.
It’s critical to follow your doctor’s presurgical instructions to minimize your risk of complications. Your doctor may tell you to stop taking certain medications or herbal supplements as well as to stop smoking. But it is expensive, takes several appointments to work, and won’t remove all the hair.
Treatment for a pilonidal cyst is usually first draining it or having surgery to remove it. However, there’s no agreement on which type of surgical procedure might be the most effective. Even with medical treatment, you may develop chronic pilonidal disease, which means your cysts keep coming back. Whenever you have surgery, it’s important to take good care of your wound so it doesn’t get infected. Your provider will tell you how to keep your wound clean (including shaving the area) and how long you should keep it covered. They’ll also tell you the warning signs of infection and when you should call your provider.
Another type of flap used for the treatment of pilonidal disease includes the Limberg or rhomboid flap. The Limberg flap excises the pilonidal disease in a rhomboid shape and rotates a fasciocutaneous flap for wound closure. Treatment can be divided into two broad categories - nonoperative vs. operative, and often there is a combination of the two. Pilonidal disease is largely considered a surgical disease, especially in acute instances with secondary infection and abscess.
In some cases, skin flaps may need to be created in order to close the wound. There is a greater risk of recurring infection if the wound is closed after surgery. Pilonidal cysts are not uncommon, and they can also cause pretty significant pain and be a burden. They do need to be treated by a healthcare provider since they likely won’t go away on their own. With the more invasive treatments, you have a lower risk of the cyst returning, though. A healthcare provider may first drain the cyst in the office.
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