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Pilonidal Cyst (cont.)

Pilonidal Cyst Diagnosis

A pilonidal cyst can be diagnosed on the basis of the characteristic symptoms and the findings on the physical exam. In general, blood work or imaging studies are usually not necessary to initially make the diagnosis.

Pilonidal Cyst Treatment

Individuals who simply have a dimple or sinus tract that has not become infected or inflamed do not generally require any immediate treatment. However, an infected pilonidal cyst may become a pilonidal abscess (pus containing structure) that requires incision and drainage (lancing) in order to improve. This procedure can generally be performed in a physician's office or in the emergency department.

  • This is done by numbing the area with a local anesthetic and making an incision with a scalpel over the infected area to open the abscess cavity.
  • The pus is drained, and any accumulated hair and debris are removed. The wound is cleaned with saline solution, packed with gauze, and covered with a bandage.
  • Antibiotics are generally not necessary unless signs of a spreading skin infection (cellulitis) are present. Pain medication will often be prescribed.

A follow-up with your physician in one to two days should be arranged to ensure adequate wound healing and to monitor for any potential complications. The wound packing will be removed by your physician, the wound will be examined, and repacking of the wound may be required if there is still purulent drainage. Treatment at home will consist of medications for pain control and diligent wound care. Sitz baths can be taken at home with warm water once the packing has been removed, and the skin wound will generally heal and close on its own in about four weeks. Keeping the wound area clean and removing any hair from around the sacrococcygeal area can help to prevent recurrence.

For those individuals with recurrent, complicated, or chronic pilonidal disease, more invasive surgery to excise the sinus or cysts may be necessary in a hospital operating room. Several different surgical procedures may be used in this case, and your surgeon will discuss the various options with you. In general, the major difference between the various surgical interventions centers around leaving the surgical wound open after surgery and allowing it to heal on its own, versus closure of the surgical wound after debridement during the surgery itself. Recovery time after surgery can take several weeks, and recurrence rates may vary depending on the choice of the surgical procedure. Potential postsurgical complications may include wound infection, poor wound healing, or recurrence.

The treatment of pilonidal disease using phenol injections is another alternative to surgery alone, although this option is more commonly employed in Europe than in the United States. Continued outpatient care and follow-up with your surgeon is necessary to ensure proper wound healing and to manage any potential complications or recurrence of pilonidal disease.

Medically Reviewed by a Doctor on 2/17/2016

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Read What Your Physician is Reading on Medscape

Pilonidal Disease »

Pilonidal disease was first reported in 1833. Sacrococcygeal pilonidal sinus is a common disorder among young adults.

Read More on Medscape Reference »

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