Pilonidal cysts are so painful because they trap hair and debris, become infected, and form a pus-filled abscess, creating intense pressure, inflammation, and tenderness, especially when sitting or moving, as the body's immune response swells the area with fluid and white blood cells, leading to significant throbbing pain.
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.
The traditional surgery for this condition is excision of the pilonidal cyst and the surrounding tissue. 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.
A pilonidal cyst is usually treated in your health care provider's office. After numbing the area, your health care provider makes a small cut to drain the cysts. If the cyst returns, you may need surgery.
Pilonidal sinus is a common disease that affects many people, including women who suffer from it during pregnancy. Pilonidal sinus occurs when the skin tissue in the coccyx area swells, and this disease is particularly painful and disturbing for pregnant women.
I had a pilonidal cyst many years ago. While it was excruciatingly painful (I seriously thought I broke my tailbone until I went to the doctor and they checked it out) and surgery wasn't exactly a walk in the park, it in no way compared to childbirth.
Your doctor will likely cut open and drain the cyst. If it gets infected again or doesn't heal, your doctor may treat it with medicines. Or the cyst may be removed using special tools and small cuts in the skin.
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.
Acute Cysts: Acute pilonidal cysts, which are typically the first occurrence, may resolve within a few weeks with proper care. This includes keeping the area clean, using warm compresses, and avoiding activities that aggravate the cyst.
Use a Donut Cushion: One of the simplest ways to reduce pain while sitting is to use a donut cushion. These cushions are designed with a hole in the middle, which helps to alleviate pressure on the affected area. By reducing direct contact with the seat, you can significantly decrease discomfort and pain.
It is a simple procedure done in your health care provider's office. Local anesthesia is used to numb the skin. A cut is made in the cyst to drain fluid and pus. The hole is packed with gauze and left open.
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.
If you've developed a painful spot at the base of your spine, you may have an infected pilonidal cyst. You may be experiencing pain that gets worse when you're sitting or laying down. You might even have pus draining from it, which can be embarrassing as well. Pilonidal cysts are very normal.
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.
A pilonidal cyst can be extremely painful especially when sitting. These cysts are usually caused by a skin infection and they often have ingrown hairs inside. During World War II, pilonidal cysts were often called "Jeep driver's disease” because they're more common in people who sit often.
Pilonidal disease is a condition that causes painful cysts or abscesses near the tailbone, often in the cleft at the top of the buttocks. One of the most common factors that aggravates this condition is prolonged sitting.
Warm water is your friend. Apply a warm, damp towel to the cyst (often near the buttock crease) for a few minutes to soothe pain and keep the area clean. Add a bit of gentle, unscented soap if needed, then pat the skin dry gently. Avoid rubbing or scrubbing—it could make the irritation worse.
Over time, untreated pilonidal cysts can grow in size, become infected, and cause severe complications, as discussed earlier. The cyst can grow large enough to interfere with daily activities, and doctors may need to perform more extensive medical procedures, such as surgery.
While pilonidal cysts can be triggered by a variety of factors such as genetics, obesity, or prolonged sitting, one of the most significant contributors to their recurrence is poor hygiene. Bacteria, dirt, sweat, and dead skin cells can accumulate in the area, leading to infection.
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.
So, about the pilonidal cyst don'ts:
While dermatologists can contribute to the overall management of pilonidal cysts, individuals requiring surgical intervention will typically be referred to a general or colorectal surgeon for definitive treatment.
Incision and drainage -- This is the most common treatment for an infected cyst. It is a simple procedure done in your health care provider's office. Local anesthesia is used to numb the skin. A cut is made in the cyst to drain fluid and pus.
Risks of surgery for a pilonidal sinus
The risks of surgery include: infection in the area where you had surgery, which can be treated with antibiotics. bleeding or a blood clot (called a haematoma).
Abscess treatment – whilst small abscesses may be lanced by your GP or in the emergency department, they commonly then recur and assessment by a surgeon is recommended even for small abscesses. A surgical drainage with or without removal of any visible sinuses may reduce the chance of future problems.