Treatment

The initial treatment for an infected pilonidal cyst is usually a procedure that can be performed in your doctor's office. After numbing the area with an injection, your doctor makes a small incision to drain the cyst. If the cyst recurs, which often happens, you may need a more extensive surgical procedure that removes the cyst entirely.

After surgery, your doctor may choose to:

  • Leave the wound open. In this option, the surgical wound is left open and packed with dressing to allow it to heal from the inside out. This process results in a longer healing time but usually a lower risk of a recurring pilonidal cyst infection.
  • Close the wound with stitches. While the healing time is shorter with this option, there's a greater risk of recurrence. Some surgeons make the incision to the side of the cleft of the buttocks, where healing is particularly difficult.

Wound care is extremely important after surgery. Your doctor or nurse will give you detailed instructions on how to change dressings, what to expect of a normal healing process and when to call the doctor. You may also need to shave around the surgical site to prevent hairs from entering the wound.

Preparing for your appointment

You're likely to start by seeing your primary care doctor. In some cases when you call to set up an appointment, you may be referred immediately to a dermatologist or a surgeon.

What you can do

Before your appointment, you may want to write a list that answers the following questions:

  • When did your symptoms begin?
  • Have you experienced this problem before?
  • Does anything improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • What medications or supplements do you take regularly?

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including:

  • Have you been running a fever?
  • Is the pain keeping you awake at night?
  • What is your occupation? Do you sit all day?
Sept. 05, 2015
References
  1. Cameron JL, et al., eds. The management of pilonidal disease. In: Current Surgical Therapy. 11th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed Aug. 15, 2015.
  2. Pfenninger JL, et al., eds. Pilonidal cyst and abscess: Current management. In: Pfenninger and Fowler's Procedures for Primary Care. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.clinicalkey.com. Accessed Aug. 15, 2015.
  3. Marx JA, et al., eds. Disorders of the anorectum. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed Aug. 15, 2015.
  4. Sullivan DJ, et al. Intergluteal pilonidal disease: Clinical manifestations and diagnosis. http://www.uptodate.com/home. Accessed Aug. 14, 2015.
  5. Pilonidal disease. American Society of Colon and Rectal Surgeons. https://www.fascrs.org/patients/disease-condition/pilonidal-disease. Accessed Aug. 16, 2015.