Pilonidal Cysts and Sinuses: Causes, Symptoms, Home Care & Treatment

Pilonidal cysts affect up to 3% (43,800) of young adults in India every year, especially men with sedentary lifestyles and excess body hair.

If you’re working in a sitting based office, you could be among the 3% of young Indians at risk of pilonidal cysts due to prolonged sitting and excess body hair.

Pilonidal sinus disease is a disease of the inter-gluteal region*, characterised by the formation of a sinus in the cleft of the buttocks. It most commonly affects males aged 16-30 years.

The most widely accepted theory for pilonidal sinus disease development begins with a hair follicle in the intergluteal cleft becoming infected or inflamed.

This inflammation obstructs the opening of the follicle, which extends inwards, forming a ‘pit’ (a characteristic feature of pilonidal sinus disease). A foreign body-type reaction may then lead to formation of a cavity, connected to the surface of the skin by an epithelialized sinus tract.

These fluid-filled cavities (cysts) will often discharge serous fluid and can periodically become acutely infected to form a pilonidal abscess.

Signs & Symptoms

A pilonidal cyst may not cause symptoms. But if it's infected, the skin around the cyst may be swollen and painful. Symptoms of an infected pilonidal cyst include:

A pit near the top of the buttocks crease.

• Pain
• Inflamed, swollen skin
• Pus or blood leaking from an opening in the skin
• An odor from draining pus

What causes a pilonidal cyst and who gets them?

The cause of pilonidal cysts has been debated since they were first recognized. Most likely, the cause may be a combination of:

Ingrown hairs. This happens when a hair is forced under the skin or when a hair follicle breaks open (ruptures).

Injury to the area. Injury, rubbing, or skin irritation may cause pilonidal cysts. This can happen from sitting for long periods of time. It can be more common in people who sit or drive a lot for work.

These cysts are often diagnosed in people between ages 16 and 26. But people of any age can have a pilonidal cyst. A person may be born with a cyst but not notice it. These cysts can affect anyone. But they're more common in males, especially those with a large amount of body hair.

Risk factors

Factors that might increase your risk of a pilonidal cyst include:

• Being a young adult white male.
• Being overweight.
• Having an inactive lifestyle.
• Sitting for long periods at a time.
• Having thick, stiff body hair.

Complications

Some people have pilonidal cysts that become infected again and again over a long time. Without treatment, these people may be at increased risk of a type of skin cancer called squamous cell carcinoma.

What is the diagnosis?

Diagnosis is usually straightforward and involves:

Physical examination: Your healthcare provider will inspect the area for lumps, dimples, or draining tracts.

Imaging: In complex or recurrent cases, MRI may be used to assess the extent of the disease, especially if multiple tracts or prior surgeries are involved.

No blood tests or advanced imaging are usually needed for simple cases.

Treating a pilonidal cyst infection

Most pilonidal cysts are left alone. But if a cyst becomes infected or inflamed, you need treatment. This may include:

Incision and drainage. If needed, the cyst is cut open, and pus and other infected material is allowed to drain.

Antibiotic medicines for the infection. Know that medicines don't make the cyst go away, and antibiotics have limited use in treating an abscess. They also won’t keep a cyst from getting infected again.

Hot water soaks. These can help draw out the infection and ease pain and itching.

Surgery to remove the cyst (excision). This may be done if the infection is severe, doesn't respond to medicine, or keeps coming back. A surgeon cuts and removes the cyst and the tissue around it. Your healthcare provider can tell you more if this is needed.

Laser hair removal around the area. This may decrease the frequency of flare-ups.

If you’re suffering with above symptoms of having itchy cysts consult MASSH for precise and effective pilonidal treatment at low price.

How to Prevent infection?

A pilonidal cyst can easily get infected. To help prevent infections:

Keep the cyst and nearby skin area clean.

Remove hair from the area of the cyst regularly. Ask your healthcare provider about safe hair removal products or procedures.

Don't sit in 1 position for long periods of time. This helps to reduce weight and pressure on your tailbone area. Sitting on a special cushion to ease pressure on the tailbone may also help. Ask your healthcare provider where to buy these cushions.

Don't wear tight-fitting clothes. Looser clothing can help reduce skin irritation around the cyst.

Home Care and Self-Care Tips

While you can’t treat a pilonidal cyst at home, you can support healing and prevent recurrences:

• Warm compresses: Applying a warm, clean towel to the area can ease pain and promote drainage after surgery.
• Sitz baths: Soaking in warm water helps relieve discomfort and keeps the area clean.
• Keep the area clean and dry: Good hygiene is crucial to prevent infection.
• Hair removal: Regularly removing hair from the area (with your doctor’s guidance) can reduce future risk.
• Avoid prolonged sitting: Take breaks and use a coccyx cushion to reduce pressure on the tailbone.
• Loose clothing: Wear comfortable, loose-fitting clothes to minimize friction and irritation.
• Pain relief: Over-the-counter pain relievers can help manage discomfort.

Important: Never try to pop or squeeze a pilonidal cyst yourself, as this can worsen infection and delay healing.

Note: Home care may help relieve mild symptoms but is not a cure for advanced or recurrent pilonidal disease.

Why choose MASSH.

At MASSH, we offer advanced, minimally invasive treatment for pilonidal cysts with faster recovery, minimal pain, and low recurrence, all managed by our team of highly experienced surgeons using cutting-edge technology in a hygienic, patient-friendly environment under affordable cost.

Busting Common Myths About Pilonidal Cysts: Facts You Should Know

MYTH 1: Pilonidal cysts are caused by poor hygiene.

FACT: While hygiene plays a role, pilonidal cysts are primarily caused by ingrown hairs, friction, and prolonged sitting, not just poor cleanliness.

MYTH 2: Only men get pilonidal cysts.

FACT: It’s more common in men, but women can also develop pilonidal cysts, especially those with risk factors like obesity or thick body hair.

MYTH 3: It’s a one-time problem.

FACT: Pilonidal cysts often recur if not treated properly. Surgical removal and proper aftercare significantly reduce recurrence.

MYTH 4: Surgery for pilonidal sinus is very painful.

FACT: With modern, minimally invasive techniques like laser or pit-picking, pain and downtime are minimal.

MYTH 5: You must be hospitalized for days.

FACT: Most pilonidal cyst treatments today are day-care procedures, allowing you to go home the same day.

MYTH 6: It will heal on its own over time.

FACT: Untreated cysts can worsen, become infected, or form abscesses. Early treatment prevents complications.