A pilonidal cyst is a pocket that develops in the skin, typically at the top of the cleft of the buttocks. This cyst contains skin debris and hair. Initially, pilonidal cysts may not cause any symptoms for the patient aside from their appearance. However, pilonidal cysts often become infected, causing a painful abscess to form.
Pilonidal cysts develop when hair punctures the skin and fails to emerge completely. Loose hairs often puncture the skin after being exposed to friction and pressure from tight clothing or other sources. After the hair punctures the skin, the body reacts to the embedded hair as though it's a foreign substance and builds a cyst around it.
Some people are more likely to develop pilonidal cysts than others. Risk factors for these cysts include sitting for long periods of time, being male, being obese, and having excess body hair. Coarse hair is more likely to cause a cyst than fine hair.
Patients should suspect infection if a pilonidal cyst becomes swollen, painful, and red. Infected cysts may also seep pus or blood. If pus is removed from an infected cyst, it will have a foul smell.
Dr. Menken offers two different types of surgical treatment for people with infected pilonidal cysts. For people with small cysts, she may numb the area and make a small incision to drain the cyst. For people with large or recurrent cysts, she may perform a more complex surgical procedure to remove the cyst entirely.
Pilonidal cysts don’t always need to be removed. However, if the cyst becomes infected, the patient will experience pain, and treatment is often necessary. Although some patients may choose to have a cyst drained when it becomes infected, pilonidal cysts tend to recur. A large, infected cyst that has recurred should usually be removed. Dr. Menken will discuss these options with patients in detail so that they can make the right choice.
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