Pilonidal cyst.

A pilonidal cyst is a cyst that develops along the tailbone (coccyx) near the cleft of the buttocks. These cysts usually contain hair and skin debris. The term pilonidal is derived from the Latin words pilus (hair) and nidus (nest). Individuals with a pilonidal cyst may not have any symptoms at all (termed asymptomatic), whereas others may develop an infection of the cyst with associated pain and inflammation. Pilonidal cysts occur more frequently in men than in women and usually occur between the ages of 15 to 24. Pilonidal cysts are uncommon after the age of 40. Pilonidal Cyst Causes: Though there are several theories, most researchers believe that pilonidal cysts are caused by the penetration of loose hairs into the skin. In response to this ingrown hair, a local inflammatory reaction causes a cyst to form around the hair. Excessive pressure or repetitive trauma to the sacrococcygeal area are thought to predispose individuals to develop the cysts and/or irritate existing pilonidal cysts. During World War II, more than 80,000 soldiers developed pilonidal cysts requiring hospitalization. Because so many of the afflicted servicemen rode in bumpy Jeeps for prolonged periods of time, it was termed "Jeep disease." Pilonidal Cyst Symptoms and Signs: As previously mentioned, some individuals with a pilonidal cyst may be asymptomatic, and the only finding may be a dimple or an opening in the skin (sinus tract) in the sacrococcygeal area. However, if the pilonidal cyst becomes infected, the following signs and symptoms may develop: pain over the lower spine, redness of the skin, warmth of the skin, localized swelling over the lower spine, drainage of pus from an opening in the skin (sinus tract) over the lower spine, or fever (uncommon). Rarely, pilonidal cysts can develop in other areas of the body such as the hands. Pilonidal Cyst Diagnosis: A pilonidal cyst can be diagnosed by your physician based on the symptoms and the findings on the physical exam. No blood work or imaging studies are usually necessary. Pilonidal Cyst Treatment: An infected pilonidal cyst is an abscess that requires incision and drainage in order to improve. Often, this procedure can initially be performed in the physician's office with local anesthesia. After numbing the area with an injection of a local anesthetic, an incision with a scalpel is made over the infected area. The physician will then drain the pus and remove hair and any other debris from the wound. The wound is then packed with gauze and allowed to heal. Antibiotics are not necessary unless your physician feels that you have a spreading skin infection (cellulitis). For those individuals with recurrent or complicated pilonidal cysts, more invasive surgery may be necessary. Several different surgical techniques may be used in this case, and your surgeon will discuss the various options with you. In general, the major difference in surgical techniques involves either leaving the surgical wound open after surgery and allowing it to heal (requiring a longer healing time but having a lower recurrence rate) versus closing the surgical wound during surgery (with a shorter healing time but higher recurrence rate). Proper wound care and follow-up with a surgeon should be arranged after either of the above procedures. Keep the wound clean and remove any hair from around the site to prevent recurrence.

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