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Pilonidal Cyst
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A pilonidal condition may be congenital or acquired. If congenital, it probably began as a defect that existed when you were born. Sometime later, the defect allowed an infection to develop. If acquired, it may be the enlargement of a simple hair follicle infection or the result of a hair penetrating the skin and causing an infection.


Risk Factors

The following factors increase your chance of developing a pilonidal abscess:

  • Personal or family history of similar problems (eg, acne, boils, carbuncles, folliculitis, sebaceous cysts)
  • Large amounts of hair in the region
  • Tailbone injury
  • Horseback riding, cycling


Talk with your doctor about the best treatment plan for you. The choice of treatment will depend on the extent of the condition and your general overall health. Treatment options include the following:

Home Treatment

As with all localized infections under the skin, hot water soaks will help draw out the infection. This will not suffice by itself, but it will hasten resolution.

Incision and Drainage

As a temporary measure, the abscess is sliced, the pus drained out, and the wound packed with sterile gauze so that it heals from the inside out. This treatment usually does not cure the problem because abnormal tissue remains.


To completely cure the condition, all involved tissue usually needs to be removed. This is a more extensive surgical procedure than simple incision and drainage. The surgical wound may be closed with sutures or left open to heal from the inside.

Laser Hair Removal

There are recent reports that laser hair removal in the area may be effective treatment for pilonidal cysts.



To help reduce your chances of getting a pilonidal abscess, take the following steps:

  • Keep the area clean and dry.
  • Avoid prolonged sitting on hard surfaces.
  • Remove hair from the area.


American Academy of Dermatology

The American Board of Dermatology


BC Health Guide

Canadian Dermatology Association


The Merck Manual . 17th ed. West Point, PA: Merck and Co; 1999.

Pilonidal disease. Palo Alto Medical Foundation website. Available at: http://www.pamf.or... . Accessed August 11, 2005.

The pilonidal support alliance. Pilonidal Support Alliance website. Available at: . Accessed August 11, 2005.

Sadick NS, Yee-Levin J. Laser and light treatments for pilonidal cysts. Cutis. 2006;78:125-128.

Last reviewed February 2008 by Ross Zeltser, MD

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