Pilonidal Cysts: How to Diagnose, Treat, and Prevent Recurrences

Last update : 29 Juin 2026

A pilonidal cyst is a sac or abscess filled with fluid. You will generally observe this painful cyst forming in the buttock cleft at the bottom of the tailbone. Generally, people who are suffering from pilonidal cysts are teenagers and young adults between the ages of 15 and the early 40s.

Key Takeaways

• You should get early treatment to ensure it doesn’t turn complicated to treat.
• The situation becomes even more urgent when you notice symptoms like severe pain and pus.
• In this condition, you must visit a colorectal or proctology surgeon because they can reduce the chances of recurrence after treatment.

You cannot ignore pilonidal cysts for too long because they are extremely painful, especially if you have to sit for long hours. Just like most health problems, pilonidal disease also starts really tiny. However, when you ignore the cyst for too long, it can turn extremely painful and larger.

You should see a dermatologist or get the right treatment when the cyst at the top of your buttocks becomes painful or swollen. 

In this guide, you will find out what is a pilonidal cyst, what are its symptoms, how to get rid of a pilonidal cyst, and the treatment process.

What Is a Pilonidal Cyst?

A pilonidal cyst patch is a sac that contains fluid. You can notice that these cysts are formed near the tailbone. These cysts are usually caused by dirt, hair, and debris around your skin. The most common symptoms of pilonidal disease are intense pain in the buttocks, redness, pus drainage, and swelling.

Quick facts box

• Young men, athletes, and drivers are at the highest risk of developing pilonidal disease.
• Young people between the ages of 15 and 26 predominantly experience pilonidal cysts.
• You can become infected and form abscesses if the skin around your buttocks has dirt, hair, and debris.

Causes and Risk Factors

Primary Causes

1. Ingrown Hair

A cyst can form when there is loose or broken ingrown hair that penetrates the skin. These ingrown hairs work like a foreign part and end up triggering the disease as a response.

2. Prolonged Sitting

One of the common causes of pilonidal cysts is prolonged sitting. Those who have a job that requires them to sit for too long while driving or working on a laptop are prone to getting this disease. Since they end up rubbing their ingrown hair on their skin due to tight clothes and prolonged sitting time, the pilonidal cyst starts developing.

3. Excess Body Hair and Sweat

Another common cause of pilonidal cysts is excessive sweating and body hair. When there is excess body hair and sweat, there are enormous chances of bacterial growth and infection. This condition of the body can increase the chances of getting a pilonidal cyst.

Here is a table exploring the risk factors for pilonidal cysts:

Table 1: A Risk Factors Table

Symptoms to Watch For

Early Signs

• Tender lump near the tailbone: You will notice small pits or tender lumps near the tailbone area. This is the first sign that you have a cyst.
• Mild discomfort when sitting: If you have started developing a pilonidal cyst, you will face difficulty and feel mild pain while sitting and standing.
• Redness or swelling: As an early sign of pilonidal disease, you will notice redness, swelling, and visible bumps around the cleft of your buttocks. This bump will often feel warm or firm when you touch it. If the swelling is expanding beyond the actual bump, then the signs are turning more advanced.

Advanced/Infected Cyst

• Severe pain: As an advanced sign of an infected cyst, you will notice intense pain around your tailbone area or lower back. This pain can interfere with your sleep and daily activities in the advanced stages of a pilonidal cyst.
• Drainage (pus or blood) with foul odour: You can notice foul odours from pus or bloody drainage. This blood usually comes from the sinus tract (a small opening in your skin).
• Fever (in rare cases): In some rare cases, you can develop fever (above 101°F), infection, dizziness, or unusual fatigue. This situation is rare because it needs urgent diagnosis, as it happens when the cyst has turned into an abscess.

How is a Pilonidal Cyst Diagnosed

Clinical Diagnosis

Generally, the doctors will start with a clinical diagnosis depending on your symptoms, which can include redness, swelling, and pain in the initial stages. The main method of diagnosing or treating a pilonidal cyst is through a physical exam. Most doctors will analyse your buttocks’ creases to identify any ingrown hair, pits, bumps, or blood drainage. They will generally inspect sinus openings and look for any signs of infection.

Imaging (If Complicated)

In the rarest and most emergency cases, the doctors will suggest you go through imaging tests like ultrasound, CT scans, or MRIs. If the doctor previously treated you for pilonidal disease, they may opt for an MRI to check for signs of recurrence. They need imaging tests if the situation is complex, and they need to find deep sinus cavities.

Treatment Options

1. Non-Surgical Treatment (Mild Cases)

The non-surgical treatment options for pilonidal cysts mainly focus on removing the pain and infection.

• Warm compresses: In the early stages, you can use wet and warm compresses to treat this cyst without any surgery. Alternatively, you can take a warm bath two times a day to reduce pain around the bump. Furthermore, this process can help the cyst drain naturally.

• Antibiotics (if infected): Although antibiotics are used to heal surrounding cellulitis, you cannot expect them to treat pilonidal cysts because they can’t remove the ingrown hair or debris. Hence, you have to ensure that you are following other non-surgical treatment options while using antibiotics.
• Hygiene and hair removal: You can reduce the chances of pilonidal cyst surgery by keeping your buttock cleft clean at all times. Additionally, you should remove hair and lose weight to reduce the chances of increasing the cyst. The patients should also avoid sitting for long hours.

2. Drainage Procedure

The drainage process for a pilonidal cyst is a minor surgical method in which the doctors are able to cure the disease. After giving the patient local anaesthesia, they will start the surgery process. 

• Incision and Drainage (I&D): The I&D is a small process in which the surgeon will open the cyst to drain out the fluid and remove infection. But this minor process won’t be able to remove the cyst completely. You might notice recurrence after a few years.

• Lancing: The doctors can use a lancing method to drain the infected pilonidal cyst. They will make a small cut to release the pus. Once the fluid comes out, you will feel the swelling has reduced, and you will get instant relief. But the lancing process does not guarantee that there won’t be a recurrence. You might need more treatments, such as a cystectomy.

• Removal of Debris: They will cut the cyst to remove the pus with debris and ingrown hair. Hence, you can expect instant pain relief after the drainage process. Although you can go home on the same day after the drainage process, you will need at least a month to completely heal the wound.

3. Surgical Removal

• Pilonidal Cystectomy: If you are looking for a surgical procedure that can remove the entire cyst and affected tissue, then you should go for pilonidal cystectomy. This method is known to prevent future infections.
• Laser treatments: Laser treatment is one of the best pilonidal cyst treatment options because the doctors are able to remove the cysts and improve the chances of healing using laser technology. 

Wondering about the effectiveness of the treatments? Here is a table exploring that:

Table 2: Treatment Effectiveness Table

Why Pilonidal Cysts Recur

According to research, the recurrence rate of pilonidal cysts is approximately 7.2%. The study found that common reasons for recurrence were prolonged sitting and high BMI. They also concluded that people in the young age group have more chances of seeing a recurrence of this disease.

There are various underlying issues that increase the chances of recurrence of pilonidal cysts:

• Hair and Debris Regrowth Into Skin: If you had a pilonidal cyst removed, keep the area near the tailbone clean and free of hair and debris. Accumulating hair in small pores increases your susceptibility to reinfection. You should make sure the area after the treatment process remains clean, and it doesn’t trap debris, which can result in new cysts.

• Incomplete Removal: Although a simple drainage process that we discussed above can remove pain and infection, this method doesn’t take out the cyst completely. If there are remnants of the cyst, you can expect the pilonidal cyst to form again. 

• Deep Sinus Tracts: Certain cysts can create sinus tracts under your skin. You cannot easily detect them or completely treat them unless the doctor has performed surgery.

• Continued Pressure and Friction From Sitting: Those who sit for long periods, especially on rigid surfaces, put immense pressure on their tailbone area. Such pressure can cause the pilonidal cyst to form again due to irritation.

• Genetic predisposition: Since some people have more body hair and sweat, they are more likely to see recurrences of pilonidal cysts.

Prevention: How to Stop Recurrences

Are you wondering how to get rid of a pilonidal cyst? If yes, then here are the tips that you can use to prevent the recurrence of a pilonidal cyst:

Daily Hygiene Tips

• Keep the area clean and dry: You should wash the buttocks area using warm water. Then, apply gentle soap and wash it again to remove any sweat, dirt, or bacteria that easily form there. 

• Shower after sweating: You should shower whenever you think your skin has turned oily due to sweat. After taking a shower, you should use a soft towel to completely dry the area around the buttocks. This process is important to ensure that there is no moisture, which can cause bacterial development.

Hair Removal Process

You should remove any unnecessary hair from your body, especially the buttocks, to stop the ingrown hair from penetrating your skin. You can use a shaving method or hair removal creams to remove unnecessary hair. But we suggest you choose laser hair removal to completely avoid the chances of recurrence.

Lifestyle Adjustments

• Reduce Sitting Time: You should avoid sitting on rigid surfaces for a long time. Sitting on rough surfaces can increase pressure and friction, which can cause pilonidal cysts to form. Even if you have to sit and work for a long time in one place, you should take 30-minute breaks. Alternatively, you can use cushion pillows while sitting to reduce pressure on the buttocks.

• Maintain a Healthy Weight: Since obesity can increase pressure around your buttocks and result in recurrence of the disease, you should try to lose weight while ensuring you are not sweating. To lose weight without sweating, you have to make changes in your diet.

Clothing Tips

• Wear breathable fabrics: You should wear loose and breathable clothes to reduce your chances of getting pilonidal cysts again. We suggest you wear cotton clothes to reduce moisture around the buttocks. 
• Avoid tight clothing: You should not wear tight-fitting clothes like jeans or thongs because they can push little ingrown hairs on your skin.

Checklist:

You can prevent or stop the chances of pilonidal cyst recurrence by following this weekly checklist:

• Use a mirror to check the area for any signs of cyst formation
• Change your towels and bedsheets once every week
• Bring loose-fitting underwear that is made of cotton fabric
• Use a doughnut-shaped pillow when sitting for long hours
• Trim or shave the buttocks area once every week or twice a month
• Keep the area clean and wash it completely using a soft towel

Post-Treatment Care

• Wound Cleaning Routine: You should gently clean the buttocks area using water. After the pilonidal cyst treatment, you should not use soap, alcohol or iodine because these things can cause irritation in your wounded area. After the cleaning process, you should use a soft towel to dry the buttocks area so that there is no moisture or chance of bacteria.

• Dressing Changes: If your wound was packed during the treatment process, you must change the dressing. You should follow the instructions of your doctor or surgeon for this process.

Recovery Timeline

Immediate Post-Treatment (Days 1–3) 

Table 3: Post-treatment Recovery Chart

Week 1: Initial Healing 

Table 4: Initial Healing Chart

Week 2: Follow-up and Transition 

Table 5: Transition Period Chart

Weeks 3–4: Progressive Healing 

Table 6: Progressive Healing Period Chart

Weeks 5–8+: Final Closure

Table 7: Final Healing Period Chart

When to See a Specialist

• Recurrent cysts: Those who have received treatment for a pilonidal cyst in the past must make a visit when they feel any signs of recurrence.
• Severe pain and persistent drainage: For a pilonidal cyst, you should see a specialist or dermatologist when you notice pus or blood drainage and feel extreme pain around your buttock cleft. 
• Fever or spreading infection: If you have a fever with other signs, then you should not wait because you need surgery. 

Most guidelines provided by the American Academy of Dermatology suggest that patients should get treated at the earliest and maintain excellent hygiene to avoid the chances of recurrence.

Summing Up

Overall, we can conclude that, although pilonidal cysts are a common problem among young adults and teenagers, they are treatable with surgical and non-surgical processes. You must choose to obtain an early diagnosis, and treating a pilonidal cyst is critical to avoid larger complications and pain. Hence, you should get the treatment immediately to get relief from pain and save yourself from going through major surgery.

For recurring cases, we will suggest that you go through the surgery process and have the underlying cyst removed completely with the surrounding tissue. To avoid getting a pilonidal cyst, you should maintain excellent hygiene and regularly remove unnecessary hair.

Get Treated For Pilonidal Cysts Today!

Never ignore the recurring pain near the tailbone area that stops you from working and sitting for long hours. 

If you get early treatment from the dermatologist, you will see faster recovery and fewer recurrences. We highly suggest you book a dermatology consultation at Union MD and seek the help of our Surgery Center if you notice any signs of a pilonidal cyst.