When Should You Visit a Doctor for a Pilonidal Cyst?

A pilonidal cyst is a frequent, though oft-misunderstood disorder that affects thousands of people every year. Situated near the tailbone at the top of the buttocks, a pilonidal cyst may be as small as a trivial irritation to a painful, repeatable medical problem, which will inhibit life. One reason people might delay getting pilonidal cyst medical treatment is because they believe the problem will be fixed by itself, or because they are ashamed of discussing symptoms in such a private part of their body. Sadly, to wait to treat the condition is a recipe for it to develop worse causing infection, abscess, and return. Recognizing the early warning signs of a pilonidal cyst and when you should seek help can minimize complications, and lead to better treatment results. If you are feeling pain, swelling, or drainage near your tailbone then understanding the importance of early evaluation may save you from having more extensive treatment on a later date.

A pilonidal cyst is an irregular pocket or cavity located in the skin at the crease between the buttocks. These cysts may also harbor hair, skin debris, and inflammation. Although physicians believed that their cause was congenital, new evidence suggests that most cases of pilonidal disease arise when loose hairs pass through the skin, causing irritation, swelling, and eventually, infection.

Pilonidal disease predominantly affects adolescents and young adults, more common among individuals between the ages of 15-40. While anybody can get the pilonidal cyst, there are some risk factors involved that increase the risk. This includes prolonged sitting, excessive appearance of body hair, obesity, family history and working where sitting for hours at a time, such as office work or truck driving.

Other individuals will have a small pilonidal cyst with no symptoms at all. Others might have sudden pain and swelling due to infection. Once pilonidal disease comes to be, however, it usually continues to be, if left untreated, a serious and recurring issue.

One of the difficulties in pilonidal disease is that early symptoms often feel trivial. Most patients think they have a pimple, ingrown hair or skin irritation. But recognizing the early signs can help stave off more serious complications. Typical symptoms of a pilonidal cyst are tenderness near the tailbone, discomfort sitting, redness or swelling of the skin, and the presence of a small pit or opening near the top of the buttock crease. The area can progress and become progressively painful and swollen as inflammation progresses. (Mayo Clinic) An infected pilonidal cyst can cause drainage. That pilonidal cyst drainage may present with pus, blood, or foul-smelling fluid that makes itself accessible through an opening in the skin. Others experience intermittent drainage during the span of months to years before starting treatments, patients said.

And if you find ongoing pain and swelling or drainage right around your tailbone, rather than waiting for symptoms to heal, attend an evaluation with a health care provider.

A frequent question patients ask, in fact, is whether the pilonidal cyst could spontaneously disappear. The answer varies with severity of disease. If the area is kept neat and free of irritation it is likely that mild inflammation might improve briefly. But once a pilonidal cyst becomes infected, spontaneous resolution is much less likely. This means many patients get into a cycle of improvement and recurrences. Symptoms can fade over weeks to months before returning more acute. And without treatment the pattern may carry on for years. Recurrences of infection can also produce new sinus tracts, complicating subsequent treatment. (PMC) While home remedies — like warm compresses, over-the-counter pain medications, and good hygiene — can provide short-term relief from discomfort, these methods do not typically erase the root cause of the disease.

Pilonidal cysts are hardly ever life threatening when they form, a few are just too quick for medical attention. A pilonidal abscess can develop rapidly – and is very painful. As the pressure builds under the skin, it makes it difficult for patients to sit, walk or do daily activities. The signs that necessitate urgent assessment are severe pain, rapidly increasing swelling, fever, chills, spreading redness, and significant drainage of pus or blood. This can be a sign that an abscess has formed and will need medical treatment. Trying to drain a pilonidal abscess at home is not recommended. If there isn’t proper treatment, infection can worsen, pain increase and appropriate care may be delayed. Patients ought to wait to see a physician who has experience with chronic pilonidal disease.

The management of the pilonidal cyst depends on the severity and the stage the disease is taking. For an acute infection or abscess, the earliest priority is relief of pain and elimination through drainage. A healthcare provider numbs the site with local anesthesia and makes a small incision during this procedure to drain the accumulated fluid and debris. This procedure often brings patients immediate pain relief.

In patients with chronic or recurrent pilonidal disease additional options might be required for treatment. Conventional surgical techniques involve taking out the affected tissue, allowing the area to heal spontaneously or through surgical closure. As of this time, new treatment practices now favour techniques that reduce recurrence and maximize healing and improve healing have become popular in modern era treatments. This involves techniques that are focused on, among other methods, off-midline closure methods, flap reconstruction techniques, and minimally invasive interventions. Your doctor will decide where to act in light of disease severity, previous episodes and your state of health.

Pilonidal disease is notoriously persistent. If contributing factors are not addressed, recurrence can continue even with successful treatment. Accumulation of hair in the buttock crease is one of the most significant contributing factors of recurrence.

In order to reduce the risk, patients will often be advised to maintain very good hygiene and reduce the pressure placed on an area and follow regular hair removal practices. Depending on the patient, this may involve shaving, depilatory creams or laser hair removal. A number of studies have demonstrated that further hair management tends to be successful in preventing subsequent reinfections.

Follow-up appointments should also take place, and patients should not hesitate to report new symptoms, such as swelling, tenderness or drainage.

Many people postpone pilonidal abscess treatment because they’re in a state of shame or wish they would get better on their own. However, pilonidal disease, usually, progresses from easy to difficult to treat. This early diagnosis enables health workers to diagnose the condition before extensive infection, chronic sinus formation or recurrent recurrences occur.

If it is pain, swelling, drainage or ongoing irritation close to your tailbone, seeing a doctor is an important way to get relief. Modern treatment for pilonidal disorder is evolving, and many patients have more efficient means to control their disease than ever before. Evaluation right away and proper treatment lead to decrease in pain, complications, and increase in the quality of your life.