A pilonidal cyst is a form of chronic inflammation characterized by the presence of an abnormal sac-like lump on the skin. This lymp is caused by ingrown hairs and is filled with hair, fluid and skin debris. This particular form of cyst usually appears in the coccyx area, that is, in the crease of the buttocks or in the cleft above the buttocks.
Pilonidal Cyst Causes
The exact cause responsible for the formation of a coccygeal cyst is probably multifactorial. These cysts are usually caused by ingrown hairs, which occurs when hair grows in the buttock fold and penetrates under the skin. A hair that penetrates under the skin can lead to an immune response of the body, which perceives the hair as a foreign body resulting in an inflammatory reaction.
Some factors that can stimulate the formation of ingrown hairs include sitting for extended periods of time, which results from an inactive lifestyle. Obesity, wearing tight clothes and anything that can increase friction, sweat and heat in the area of the buttocks can contribute to the manifestation of this particular form of inflammation. These conditions can also irritate hair follicles, which can fill with dead skin cells and bacteria, leading to cyst formation.
Other risk factors for developing a pilonidal cyst include a previous onset or family history of the condition. Younger men are at a higher risk of developing a coccyx cyst. They usually appear after puberty due to changes in hormones and increased hair growth during this time, but can develop up to the age of 40. These cysts can also be congenital and present at birth.
At the same time, it can be caused by some trauma or irritation before the manifestation of the symptoms. If a pilonidal cyst becomes infected due to lack of treatment, a painful skin abscess may develop. If this chronic inflammation is not properly treated, the person may be at risk of developing some form of malignancy in the skin area, although this is a rare case.
Pilonidal Cyst Symptoms
The most common symptoms of a pilonidal cyst include the presence of a small lump or irritated mass in the coccyx area between the buttocks. This is typically characterized by inflammation, redness, swelling, tenderness, and pain that worsens when the patient walks or sits. An infected pilonidal cyst in several cases is accompanied by a discharge of purulent fluid or blood combined with an unpleasant odor. Some people may experience nausea, fever, or extreme fatigue with acute inflammation, but these symptoms are less common. When this particular cyst causes symptoms, it can take either an acute or a chronic – recurrent form.
Pilonidal Cyst Diagnosis
A pilonidal cyst is diagnosed by physical examination and taking the patient’s history. The attending physician carefully examines the affected area to locate the cyst. In rare cases where infection is suspected, blood tests, a urine sample and a fluid sample are recommended. In some cases, further investigation of the condition by X-ray, CT or MRI may be needed to inspect the cavities or depth of the cyst and the extent of the infection.
Pilonidal Cyst Treatment
Treatment for a pilonidal cyst varies depending on the severity of symptoms and the extent of the inflammation. In case of absence of symptoms, it is recommended to thoroughly shave and maintain proper hygiene of the area. In very mild cases, oral and/or topical antibiotics may be prescribed while the patient is monitored regularly.
However, while antibiotics can help relieve inflammation, they may not completely cure the condition. Less common treatments include phenol injections to treat and prevent mild to moderate symptoms. This method, however, is associated with a higher recurrence rate, is quite time-consuming, and is usually not recommended.
In cases of severe symptoms, surgery is recommended to treat the condition. The most common surgical treatment for a pilonidal cyst is to make an incision on the surface of the cyst and drain its interior. During this procedure, a small incision is made in the cyst, through which any fluid, hair and debris that it may contain is released to prevent infection. The wound is then either left open to heal on its own or sutures are placed to close it. If an infection has already occurred or is suspected, this procedure is useful to drain the pus and is usually accompanied by drug therapy with antibiotics. However, this condition is characterized by high rates of recurrence.
The most modern treatment method, which minimizes the possibility of recurrence of the condition, is pilonidal cyst treatment with laser. This particular treatment is minimally invasive, bloodless and painless, while in the majority of cases it offers definitive relief from the condition.
