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Pilonidal Cyst: Symptoms and Treatment

The pilonidal cyst or hair follicle fistula is located in the lower part, the tail of the spine between the gluteal muscles. The main cause of its appearance are the hairs that enter the skin, due to constant friction in the area. However the causes of pilonidal cyst are unclear.

Who Are Most Likely to Develop Pilonidal Cyst?

The pilonidal cyst is found mainly in young people, aged between 15 and 25 years with high hair growth and with a higher frequency in men than in women (ratio 3:1). You may develop a coccyx cyst from:

You can develop a pilonidal cyst from:

  • A hair follicle that is irritated by exercise due to friction, tight clothing, or heavy sweating and a sedentary lifestyle.
  • An ingrown hair that causes irritation.
  • Change in hormones.

  Another theory is that pilonidal cysts can appear after an injury to that area of your body or if you were born with a small dimple in the skin between the buttocks, you are more prone to develop a pilonidal cyst.

   During World War II, more than 80,000 soldiers developed coccyx cysts and were hospitalized. People thought it was due to irritation from driving bumpy Jeeps. For a time, the condition was called "Jeep disease."

Pilonidal Cyst : Symptoms

Pilonidal cyst can be acute or chronic. When the symptoms appear intense and are quite painful, then it is in an acute form and this indicates that an abscess has been created with inflammation. On the contrary, in the case of chronic pilonidal cyst, the symptoms are not so intense and in some cases it can be detected accidentally by the patient, since there is no inflammation, there are no symptoms. If you notice the following symptoms, it is advisable to contact your doctor.

  • Pain in the lower back, in the region of the coccyx (intergluteal region), especially when sitting.
  • Redness and swelling at the base of the spine.
  • This swelling oozes pus from the fistula that has formed and has an unpleasant odor. In some cases, blood may also clot.
  • Sensitivity to touch.
  • Sometimes there might be fever.

How to Reduce Symptoms of Pilonidal Cyst at Home?

   In the early stages of a pilonidal cyst, the pain and symptoms may not be as severe. However, it is good to avoid sitting for long periods of time, as well as it is important to maintain the hygiene of the area by washing often. Obesity can worsen the condition of the pilonidal cyst, as friction is greater and it is more difficult to keep the area clean. Therefore, it is more prone to infections. Also when sitting, place a pillow to relieve pressure on the area or you can lie down.

   However, in case of an acute pilonidal cyst, you can alleviate the pain by placing some ice wrapped in a cloth for a short time to reduce the inflammation. You can also take a painkiller in consultation with a doctor, for pain relief. Be sure to keep the cyst area clean and dry to prevent further infection. Hair removal of the area contributes significantly to reducing recurrence in the future.

Prontosan Wound Irrigation Solution is a colorless solution with 0.1% polyexanidine and 0.1% betaine, ideal for flushing and cleaning fistulas and abscesses such as a pilonidal cyst. Thanks to the combination of these two substances, the healing process is greatly accelerated and the biofilm that may have formed on the wound is effectively destroyed, and also prevents its formation.

 If you have a pilonidal cyst that is infected you can use Prontosan Wound Irrigation Solution to prevent further infection. Its use is also suitable after the surgical operation of the pilonidal cyst where the wound remains open and exposed to germs. Healing is painless and quick without complications. You can also soak a gauze pad in the Prontosan solution and place it on the wound.

Pilonidal Cyst Treatment

There are different treatment methods for pilonidal cyst. Your doctor will decide which treatment is right for you taking into account various factors such as the severity of your symptoms, whether an abscess has formed, your recovery time and many others. In the end, the treating physician or surgeon will individually choose the treatment.

Pilonidal Cyst Drainage

This procedure can happen right in the doctor's office. In the early stages, an antibiotic can be given and the doctor will open the cyst, remove the fluid and the inflammation will subside. The wound remains open until it heals, however, this method does not ensure the definitive treatment of the cyst as it may recur in the future . Hair removal of the area also plays a very important role in order to eliminate the possibility of hair entering the wound and the subsequent monitoring of the situation by cleaning the area.


Surgery is usually recommended when the symptoms are very severe, the extent of the abscess is large, and there has been re-inflammation in the past. The surgery can be done under general or local anesthesia and the attending surgeon can leave the wound open or close it with stitches. In the first case, the surgeon leaves the wound open and fills it with a bandage. This allows the area to heal from the inside out. This process takes longer, but makes it less likely that the cyst will return.

In the second case, the surgeon closes the wound with stitches, which requires a shorter healing time, but has a greater risk of recurrence of the cyst.

Wound care is very important after surgical procedures. After surgery, the wound needs daily care with frequent gauze changes that can be done in the doctor's office but also at the patient's home. Prontosan Wound Irrigation Solution helps not only to heal the wound quickly but also change the dressings placed on the open wound without any pain.

Laser Treatment

Laser treatment is done with an endoscopic beam of radiation, a thin, flexible tube that enters the fistula and due to the photothermal, destroys the hair and the fluid as well as necrotic tissue that is under the walls. It is the least invasive treatment as no incision is needed. The recovery time is very fast compared to previous treatments. However, it is indicated for small and medium-sized fistulas.

Injectable Therapy

Phenol injections can treat and prevent mild and moderate pilonidal cysts. Phenol is an acidic chemical compound that acts as an antiseptic inside the cyst. This process may take several iterations. causing the wound to harden and heal. A negative feature of this treatment is the possibility of recurrence of pilonidal cyst in the future.

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