Yes, you should go to the ER or urgent care for an infected pilonidal cyst (abscess) showing signs like severe pain, significant swelling, redness, warmth, fever, or draining pus/blood, as it needs prompt drainage and treatment to prevent the infection from spreading. While some mild cysts can wait for a GP, an abscess requires immediate attention from a doctor, surgeon, or ER to lance and drain it.
The best way is to drain it off the “midline,” so the pilonidal wound has the quickest and best chance of healing. If neither is available immediately, contact your primary care doctor or go to your nearest urgent care center or emergency room.
If your pilonidal cyst is causing persistent pain or discomfort, it's an indication that you should have it evaluated. The level of discomfort can vary from person to person, but if you're bothered by your cyst — seek care.
However, you should definitely see a doctor if your cyst displays any of these symptoms: Yellow discharge, which could indicate an infection. Pain, tenderness, or redness. A rapid change in size, color, or shape.
You're likely to start by seeing your primary care provider. In some cases when you call to set up an appointment, you may be referred immediately to a surgeon or to a doctor who specializes in treating skin conditions, called a dermatologist.
Urgent advice: Ask for an urgent GP appointment or contact NHS 111 if: you have a small lump at the top of your bottom (between your buttocks) that's painful, bleeding or leaking pus.
In a study of pilonidal excisions, one group of patients reported an average pain level of 6.5. Another group's average rating was 7.4.
Seek emergency medical attention if you also have abdominal pain with: Severe nausea and vomiting (may indicate ovarian torsion) Fever (may indicate infection) Heavy vaginal bleeding.
If left untreated, benign cysts can cause serious complications including: Infection – the cyst fills with bacteria and pus, and becomes an abscess. If the abscess bursts inside the body, there is a risk of blood poisoning (septicaemia).
We treat an abscess by draining it and removing all the infected tissue. Some abscesses drain by themselves, but you usually still need a procedure to clean the area. We can drain most abscesses in the emergency department (A&E) or our emergency general surgical clinic under a local anaesthetic.
Chronic Pilonidal Disease: Chronic pilonidal disease refers to recurring or persistent cysts. These can last for months or even years without treatment, and they are unlikely to go away on their own.
❖ If the cyst is infected, there is often pain, redness, and/or swelling at the top of the buttocks crease. This can make it uncomfortable to sit or lie down. Fever can also develop. If the cyst or abscess bursts, it may drain fluid, blood, or pus (a creamy white, green, or yellow discharge).
Untreated pilonidal cysts can further lead to complications such as cellulitis, chronic infection, and abscess formation. Although uncommon, pilonidal disease can transform into carcinoma similarly to that of other chronically inflamed wounds such as osteomyelitis, scars, skin ulcers, and fistulas [3].
These include skin redness, swelling, warmth, and pain. The pain may be throbbing, burning, sharp, or dull. In severe cases, fever and chills may be present. The patient may not be able to sit in a comfortable position.
Surgery is needed to drain and remove a pilonidal cyst that does not heal. Your provider may recommend this procedure if you have pilonidal disease that is causing pain or infection. A pilonidal cyst that is not causing symptoms does not need treatment.
Pilonidal cysts usually occur when hair punctures the skin and then becomes embedded. If a pilonidal cyst becomes infected, it can be very painful. The cyst can be drained through a small cut in the skin. Sometimes, surgery is needed.
Skin cysts do not need to be treated if they're not causing any problems. But treatment may be recommended if you have: an infected skin cyst – you may be given antibiotics. a large, painful cyst which interferes with everyday life – for example, a cyst on your head that catches when you brush your hair.
Infection. If a cyst becomes red, swollen, warm to the touch, or increasingly painful, it may indicate an infection. Infected cysts can lead to complications and require medical treatment.
We would not normally remove a cyst whilst it is infected because there is a high risk of infection in the wound and poor wound healing. A course of antibiotics will often settle an acute infection and it is not uncommon for some cysts to resolve without treatment.
If you have been diagnosed with an ovarian cyst and get sudden, severe lower tummy pain, go to your nearest A&E department straightaway. You may need to have surgery. Although most ovarian cysts are benign, there's a potential risk they may be or may become cancerous.
Emergency rooms will treat cysts when they become infected, painful, or pose immediate health concerns. Emergency cyst treatment is typically indicated in the following situations: Infected cysts with redness, swelling, warmth, and pus requiring immediate drainage and antibiotic treatment.
If the cyst swells and/or causes discomfort, use a warm compress over the cyst to reduce symptoms at home. If your symptoms continue or get worse, contact a provider. They may recommend removing it, or they'll inject a steroid medication into the cyst to temporarily reduce swelling.
How Are Pilonidal Cysts Treated? An active pilonidal abscess must be drained, and this can usually be done in the emergency room or the office under local anesthesia. After the urgent problem is addressed, a measured plan of action must be undertaken to prevent recurrence or worsening of symptoms.
A pilonidal cyst is a pocket of hair and skin debris under the skin, and it is always in the tailbone area, or butt crease, or slightly off to the side. A small one might be about the size of a pea, and a large one the size of a walnut.
Key Takeaways