Pilonidal Abscess

Pilonidal Abscess surgery lines

Pilonidal Abscess definition

Pilonidal abscess refers to a cyst or an abscess found in the cleft of the buttocks. The cyst is fluid-filled and it happens in the tailbone or what is called as the coccyx. The abscess is caused by skin debris and hair. A sinus tract may also develop. The pilonidal cyst happens because of the presence of bacteria that grows in the buttocks area. However when no treatment is done, it will become an abscess and will progress to an infection.

Pilonidal comes from a Greek word that means “nest of haor” It was first used by Herbert Mayo to describe the disease where he combined the word “pilus” which is a Greek term for hair and “nidu” for nest.

Pilonidal Cyst Symptoms

The pilonidal cyst or abscess although is mostly found in the buttocks area or the coccyx can also be found in the armpit, genital, as well as the navel. There are cases where the abscess is asymptomatic and there are also instances where it is painful and symptomatic. Some of the signs and symptoms are:

  1. Redness
  2. Pain on the lower back or the spine
  3. Warm to touch
  4. Swelling in the lower back which is localized
  5. Pus drainage on the lower back
  6. Fever may also occur but it happens rarely

Pilonidal Cyst Pictures

Pilonidal Abscess PICTURES

Picture 1 : Pilonidal Abscess

Image source : ramsayhealth

Pilonidal Abscess

Picture 2 : Pilonidal  cyst and Pilonidal dimple picture

pilonidal cyst picture
Pilonidal cyst removal photo

Pilonidal Abscess Causes

Research says that the abscess or cyst does not happen through inheritance or disease. Instead, this is acquired from other sources especially if the area is infected causing cyst to occur. The pilonidal abscess is mainly a rare form or illness or disease because it only affects about 26 people per 100,000 live births. This mostly affects Caucasian males over Caucasian females. It also happens between 15 to 24 years old but it can also happen to those who are on their 40’s. However, this occurs rarely.

The cause of the pilonidal abscess can be related to the deeper penetration of the hair into the subcutaneous tissues. Normally the skin has hair follicles and it is found in the dermis. In this disorder, the hair follicles are dilated and penetrates deeper. This will then be perceived as a foreign material or a bacteria and the immune system attacks the site causing local inflammation. The inflammatory response creates a cyst that encapsulates the hair.

Another probable cause is that if there are injuries to the sacrococcgygeal area. The frequent friction on the site as well as the trauma can cause follicles to dilate and go deeper into the subcutaneous tissues. An individual who also sits for a long time or a trauma on the hips or sacral area along with obesity are some of the factors. Hirsutism or a condition where there are a lot of hairy or copious hair can also be a factor.

Pilonidal Cyst Treatment

The Pilonidal abscess has a good prognosis especially when treatment comes early. Some of the treatment options include:

a. Medical treatment

This includes taking of different medications religiously to avoid regrowth of the abscess or cyst. Some of the medications are:

  • Iodex. This is an antibacterial ointment. This is best to be used at night because the ointment stains the clothes when putting on the buttocks area.
  • Antibiotics. These are taken orally to help in killing the bacteria that causes the cyst. This also helps by giving comfort when there is pain flares up. It is important to drink the recommended dosage and finish the antibiotic treatment because there will be bacterial resistance once the medication is not fully taken.
  • Homeopathic remedies. These are also called as the alternative medicines where application of tea tree oil or tree oil or colloidal silver concoctions are used to give remedy to the problem. It is important however to know the product thoroughly and make sure that it is legitimate.
  • Pilonidal Cyst Removal (pilonidal cystectomy).  The pilonidal cyst can be surgically removed. It involves local or general anesthesia and you may be given a sedative to relax you and your muscles. If the cyst is infected then the surgeon may first make a cut into the cyst to remove the fluid and puss.

This is a sensitive disease and self medication is definitely not the best thing to do. Should you suspect that you have this, there’s no better thing but to proceed to a doctor for proper medication.

b. Lifestyle changes

  • Hygiene. This is a very important factor in treating or taking care of the abscess. It is important to wash the area and take a regular shower as well. It is also crucial to wash the lower back area with soap and water so that the bacteria lounging at the back or at the coccyx are eliminated.
  • Exfoliation. Simple hygiene won’t do the trick. Exfoliating the skin once in a while is also important. Washing only helps remove the bacteria but it does not remove the dead skin cells, dust and other dirt in the back area. These are also believed to be some of the causes of pilonidal abscess or cyst formation.
  • Posture. It is important to have a proper posture when sitting because it can flare-up or aggravate the pilonidal abscess. When there is poor posture, the weight of the body is carried or directed to the area of the coccyx or the tailbone. The increase in pressure will cause the hair follicles to penetrate deeper into the subcutaneous. Then the inflammatory process begins. Having a good posture will not only help avoid the aggravation of the pilonidal cyst but it also avoids back pains.
  • Having cushions. There are jobs especially office works where they need to sit and face their computers or do paper works. There is a great pressure generated on the back. One way to relieve the pressure is to use cushions on the seat. It is best to get a good coccyx cushion because these help avoid pressure and aggravation of the pilonidal abscess.

Pilonidal abscess surgery:


This is a surgical option where the secretions are drained on the sinus opening of the pilonidal abscess. This is very much suggested in times of flare-ups. The surgical procedure is done by doctors and ensures that the pus are all excreted or drained. Then the area is covered with a gauge and bandage to secure the site. This is done to avoid exposing the wound and attracting infection.

Pilonidal Abscess surgery lines

Picture: Pilonidal Abscess Surgery (cleft-lift procedure)

Image source: pilonidalsurgery.com

Complications of Pilonidal Abscess:

If the problem is not solved right away, the simple cyst which can be acted upon quickly will complicate and cause more problems like the formation of abscess, systemic infection which are hard to deal with because the infection spreads to the different parts of the body. Lack of attention can also result to squamous cell carcinoma; a rare skin cancer.


Please enter your comment!
Please enter your name here