Your health care provider may be able to diagnose a pilonidal cyst by asking about your symptoms, medical history and personal habits and by looking at the affected skin.


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.

If you need surgery, your health care provider numbs the area and removes the cyst through an incision.

After removing the cyst, your health care provider might:

  • Leave the wound open. In this option, the surgeon leaves the wound open and packs it with dressing. This allows the area to heal from the inside out. This takes longer but makes it less likely the cyst will come back.
  • Close the wound with stitches. In this option, the surgeon closes the wound with stitches. This process results in a shorter healing time but has a greater risk of the cyst coming back.

Wound care is very important after surgery. Your health care provider will show you how to change dressings and explain what to expect during the healing process. You'll also be told when to call your health care provider. You may 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 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.

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 health care provider is likely to ask you a number of questions, including:

  • Have you had a fever?
  • Is the pain keeping you awake at night?
  • What is your occupation? Do you sit all day?
Dec. 16, 2022
  1. Roberts JR, et al., eds. Incision and drainage. In: Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed Sept. 21, 2022.
  2. Pilonidal disease. American Society of Colon and Rectal Surgeons. https://fascrs.org/patients/diseases-and-conditions/a-z/pilonidal-disease. Accessed Sept. 21, 2022.
  3. Ferri FF. Pilonidal disease. In: Ferri's Clinical Advisor 2023. Elsevier; 2023. https://www.clinicalkey.com. Accessed Sept. 21, 2022.
  4. Cutaneous cysts. In: McKee's Pathology of the Skin. Elsevier; 2020. https://www.clinicalkey.com. Accessed Sept. 21, 2022.