Pilonidal abscess; Pilonidal dimple; Pilonidal disease; Pilonidal cyst; Pilonidal sinus
A pilonidal cyst is a pocket that forms around a hair follicle in the crease between the buttocks. The area may look like a small pit or pore in the skin that contains a dark spot or hair. Sometimes the cyst can become infected and this is called a pilonidal abscess.
An infected pilonidal cyst or abscess requires surgical drainage. It will not heal with antibiotic medicines. If you continue to have infections, the pilonidal cyst can be removed.
There are several types of surgery:
Incision and drainage: This is the most common treatment for an infected cyst. It is a simple procedure done in the doctor's office.
Pilonidal cystectomy: If you keep having problems with a pilonidal cyst, it can be removed surgically. This procedure is done as an outpatient procedure, so you will not need to spend the night in the hospital.
It may be hard to remove the entire cyst, so there is a chance that it will come back.
Surgery is needed to drain and remove a pilonidal cyst that does not heal.
Non-surgical treatment may be used if the area is not infected:
Pilonidal cyst resection is generally safe. Ask your doctor about these complications:
Tell your health care provider:
After the procedure:
Pilonidal cysts come back in about half of the people who have surgery the first time. Even after a second surgery, it may come back.
Ford DH, Bailey HR. Pilonidal disease. In: Yeo CJ, ed. Shackelford's Surgery of the Alimentary Tract. 7th ed. Philadelphia, PA: Elsevier Saunders; 2013;chap 149.
Steele SR, Perry WB, Mills S, Buie WD, Standards Practice Task Force of the American Society of Colon and Rectal Surgeons. Practice parameters for the management of pilonidal disease. Dis Colon Rectum. 2013;56:1021-7. PMID: 23929010
Sternberg JA. The management of pilonidal disease. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 11th ed. Philadelphia, PA: Elsevier Saunders; 2014;293-301.
Last reviewed on: 4/5/2015
Reviewed by: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.