Skin Disorders

Skin disorders cover a wide range of conditions, some benign, some very serious, and some even a sign of another underlying illness. A skin disorder not only affects your physical health, but also your emotional well-being.

Skin Care › Skin Disorders › Pilonidal Cyst

Pilonidal Cyst - Treatment & Surgery (Pictures)

A pilonidal (PIE-low-NI-dal) cyst is a sac under the skin at the base of the spine. It looks like a small hole, often with a few hairs coming out. The cyst may become infected. Pilonidal cysts are most common in young men. The most common place for a pilonidal cyst to develop is in the skin over the tailbone, just over the cleft in the buttocks. Friction and pressure on the area aggravate the condition along with the presence of bacteria. People are not born with this condition but develop it in the late teens, twenties or thirties. Trauma or injury to the are may cause the cyst to become very tender and painful, producing swelling and drainage.

Causes of Pilonidal cyst

Pilonidal cysts are usually caused by ingrown hair in the folds of the skin. Hair may become ingrown because of friction (rubbing) or irritation near the bottom of the spine. The friction causes hair to dig into the skin and get trapped there. Pilonidal cysts may become infected, and cause an abscess (AB-ses). An abscess is a localized collection of pus in a cavity or pocket.

• Tight fitting diapers or clothing that rubs against the skin can lead to a rash.
• Antibiotics kill bacteria - both bad and good. Without the right balance of good bacteria, however, yeast infections can occur. This can happen when babies take antibiotics or when mothers, who are breast-feeding their infants, are taking antibiotics.

Signs and symptoms of Pilonidal cyst

Signs and symptoms can vary from a small painless pit or dimple at the base of the spine to a large painful abscess. Most patients go to the doctor complaining of progressive tenderness, particularly after prolonged periods of sitting, such as during a long drive. Signs and symptoms include:

• Your skin may hurt and look red and swollen if the cyst fills with pus and becomes infected
• Small hole or holes draining fluid that may be clear, cloudy or bloody
• If infected the draining pus may have a foul odour.
• A pus-like discharge may come from the cyst.
• You may feel fever, malaise or nausea.
• An infection will also usually have surrounding red skin as well as exquisite tenderness when touched.

Pilonidal Cyst Diagnosis

No medical tests are usually necessary to diagnose pilonidal disease. Doctors are not sure what causes a pilonidal cyst . One theory is that a small and harmless cyst has always been present at birth, and that for some reason, it has become irritated and formed a painful abscess. Another explanation is that it is an ingrown hair that has formed an abscess. It is common to find hair follicles inside the cyst-according to some statistics approximately fifty percent of the cysts drained are found to contain hair follicles, though this is not thought to be the sole cause of the condition.

Treatment for Pilonidal cyst

Treatment consists of antibiotics if the area is infected. After the infection is cleared, a day surgery procedure to remove the cyst is performed. The cyst may be a simple abscess or may be draining from sinus tracts that need to be closed. The process of raising the borders of the emptied cyst and stitching them to form a pouch is called marsupialization. The interior of the pouch then empties the collection of pus and gradually closes. Several weeks of packing the pouch with gauze is needed to collect the pus while the pouch closes. Please feel free to ask any member of the pediatric surgery team if you have any further questions.

Surgery on a cyst in the tailbone area involves cutting out the skin and flesh all the way down to the coccyx and allowing the body to regrow the ablated tissue. Varying methods are used to either pack the wound, or suture it partially and even completely, depending on the physician's opinion on how best to treat the patient. The condition can recur, even after surgery. Some people have a chronic problem with this, while most others never have the condition again after surgical treatment.

Tips on preventing and treating Pilonidal cyst

• Avoid tight clothing.
• Do not take tub baths or showers until the gauze is removed. You may wash at the sink.
• Avoid sitting on hard surfaces for long periods.
• Shave the area if your health professional advises.
• Keep the area dry and clean.
• Multiple surgical procedures are available for resolution. The exact surgical technique should be discussed with your surgeon.
• After the gauze is removed, apply a warm, wet wash cloth to the area or sit in a tub of warm water for 15 to 20 minutes several times a day to relieve the pain. Then clean the wound gently with mild, unscented soap.