Pilonidal cyst

DEFINITION

A pilonidal (pie-low-NIE-dul) cyst is an abnormal pocket in the skin that usually contains hair and skin debris. A pilonidal cyst is almost always located near the tailbone at the top of the cleft of the buttocks.

These cysts typically occur when hair punctures the skin and then becomes embedded. If a pilonidal cyst becomes infected, the resulting abscess is often extremely painful. The cyst can be drained through a small incision or removed surgically.

Pilonidal cysts most commonly occur in young men, and the problem has a tendency to recur. People who sit for prolonged periods of time, such as truck drivers, are at higher risk of developing a pilonidal cyst.

CAUSES

There is some disagreement about what causes pilonidal cysts. Most pilonidal cysts appear to be caused by loose hairs that penetrate the skin. Friction and pressure — skin rubbing against skin, tight clothing, bicycling, long periods of sitting or similar factors — force the hair down into skin. Responding to the hair as a foreign substance, the body creates a cyst around the hair.

This explanation accounts for rare cases of pilonidal cysts that occur in parts of the body other than near the tailbone. For example, barbers, dog groomers and sheep shearers have developed pilonidal cysts in the skin between fingers.

Another possible explanation is that normal stretching or motion of deep layers of skin causes the enlargement and rupture of a hair follicle, the structure from which a hair grows. A cyst then forms around the ruptured follicle.

SYMPTOMS

When it’s infected, a pilonidal cyst becomes a swollen mass (abscess). Signs and symptoms of an infected pilonidal cyst include:

  • Pain
  • Reddening of the skin
  • Drainage of pus or blood from an opening in the skin
  • Foul smell from draining pus



When to see a doctor

If you notice any signs or symptoms of a pilonidal cyst, see your doctor. He or she can diagnose the condition by examining the lesion.