A pilonidal (pie-low-NIE-dul) cyst is an abnormal pocket in the skin that usually contains hair and skin debris. A pilonidal cyst is almost always located near the tailbone at the top of the cleft of the buttocks.

These cysts typically occur when hair punctures the skin and then becomes embedded. If a pilonidal cyst becomes infected, the resulting abscess is often extremely painful. The cyst can be drained through a small incision or removed surgically.

Pilonidal cysts most commonly occur in young men, and the problem has a tendency to recur. People who sit for prolonged periods of time, such as truck drivers, are at higher risk of developing a pilonidal cyst.



When it's infected, a pilonidal cyst becomes a swollen mass (abscess). Signs and symptoms of an infected pilonidal cyst include:

  • Pain
  • Reddening of the skin
  • Drainage of pus or blood from an opening in the skin
  • Foul smell from draining pus
  • Fever



There is some disagreement about what causes pilonidal cysts. Most pilonidal cysts appear to be caused by loose hairs that penetrate the skin. Friction and pressure — skin rubbing against skin, tight clothing, bicycling, long periods of sitting or similar factors — force the hair down into skin. Responding to the hair as a foreign substance, the body creates a cyst around the hair.

This explanation accounts for rare cases of pilonidal cysts that occur in parts of the body other than near the tailbone. For example, barbers, dog groomers and sheep shearers have developed pilonidal cysts in the skin between fingers.

Another possible explanation is that normal stretching or motion of deep layers of skin causes the enlargement and rupture of a hair follicle, the structure from which a hair grows. A cyst then forms around the ruptured follicle.


Risk Factors

Certain factors can make you more susceptible to developing pilonidal cysts. These include:

  • Obesity
  • Inactive lifestyle
  • Occupation or sports requiring prolonged sitting
  • Excess body hair
  • Stiff or coarse hair
  • Poor hygiene



If a chronically infected pilonidal cyst isn't treated properly, there may be a slightly increased risk of developing a type of skin cancer called squamous cell carcinoma.



To help prevent pilonidal cysts, try to:

  • Keep the area clean
  • Lose weight if needed
  • Avoid prolonged sitting

If you've had pilonidal cysts in the past, you might want to regularly shave the area or use hair removal products to reduce the risk of recurrence.




In this procedure the surgeon does a wide bore local excision of the skin containing the sinus tract. The resulting cavity is left open to heal and fill in naturally from the bottom upwards. The wound is kept covered with a dressing.
The disadvantage of wide excision is that the wound size is large and healing may take upto 3 months. The dressing needs to be changed daily making it a tedious process. However the procedure is safe with a recurrence rate of 10-15%.


This is a minimally invasive procedure done using the Leonardo laser. This laser was first introduced in India by Dr. Ashwin Porwal at Healing Hands Clinic. In LPP, a small cut is made on the skin and all the pus is drained out. The entire sinus tract is then sealed with the laser fibre.


Advantages of LPP :

  • Patient is discharged within 24 hours and can return to routine work by the 5th day.
  • Wound healing occurs in about 6-8 weeks and thus recovery is much faster as compared to conventional Wide excision.
  • Recurrence rate is negligible.