A pilonidal cyst is an irregular sac that develops in a particular region of the body - adjacent to the tailbone i.e. coccyx situated at the base of the spine and above the crevice of the buttocks. It is an aberrant structure that comprises hair and debris of skin cells, which forms in the lower back when hair invades the deeper dermal layers and gets implanted in the area. In some cases, microbes and germs enter and multiply in the pilonidal cyst, which then becomes infected and is referred to as a pilonidal abscess. Besides abscesses, pilonidal cysts can also result in vacant pockets below the surface of the skin known as sinus cavities, if left unattended.

Also Read: Abscess: Causes, Symptoms And Treatment

A pilonidal cyst is also termed intergluteal pilonidal disease or pilonidal cyst disease. It invariably instigates pain and discomfort when sitting for a long time due to its location in the skin between the tailbone and anus, along the crease of the buttocks. It is a very common skin condition that can either be acute and disappear completely after treatment, or keeps recurring and presents itself in a chronic form. Pilonidal cysts mostly arise from skin infections and almost always exhibit ingrown hairs, similar to folliculitis. To avoid severe infections on the skin atop the tailbone, it is necessary to report any symptoms of pilonidal cysts as soon as they are noticed to the doctor, to identify the causes and effectively treat the skin disorder.

Also Read: Folliculitis: Causes, Symptoms And Treatment

Causes Of Pilonidal Cyst:

While it is clear that microbial infections surrounding ingrown hairs near the tailbone prompt a pilonidal cyst, the precise reason as to why vast amounts of ingrown hairs originate in that region is not yet determined.

Certain loose strands of hair that get affixed onto the lower back are pushed into the deeper layers of skin tissues from high friction and pressure, by sitting for lengthy phases, cycling long distances or donning tight attire. This also triggers the formation of a cyst in the low back area.

Risk Factors:

This common skin condition arises in both men and women, but certain people are more susceptible to developing a pilonidal cyst, such as:

• Men of all age groups, who are more prone to this skin ailment than women
• Young people, between the ages of 20 to 40
• Individuals who are in occupations that involve remaining sedentary for prolonged intervals, such as truck drivers, office employees
• Men and women who wear very tight-fitting clothes for an extended period of time
• Persons who have inherently coarse, thick hair on their body
• People who are overweight or diagnosed with obesity

Symptoms:

The characteristic indications of a pilonidal cyst comprise:

• Low back pain, which is sharp and becomes more prominent when sitting down
• Redness in the vicinity of the tailbone
• Swelling of skin and tender lumps in between the buttocks
• A pus-filled abscess in the skin near the tailbone, sometimes accompanied by bleeding
• Unpleasant odour arising from skin infections oozing pus, in the back
• Feeling nauseous, with fever and exhaustion

Diagnosis:

The dermatologist, a doctor specializing in studying skin conditions, usually performs a thorough physical examination of the skin in the body. They particularly check the skin close to the buttocks, to look for any obvious signs of a pilonidal cyst, such as pus-filled inflammation with ingrown hairs, reddening and soreness.

The healthcare provider also questions the patient on how long they have had the cyst, as well as when they first noticed pus coming out of it and if it has become bigger in size. With this information and detailed external investigation of the skin in the lower back, the diagnosis of pilonidal cyst can be ascertained.

Treatment:

Once the instance of a pilonidal cyst is confirmed, the physician initiates the appropriate course of treatment based on how grave the symptoms are. If the tender bump is occurring for the first time in the patient, then the doctor carries out a procedure in the clinic to drain the cyst, by carefully drawing an incision after anaesthetizing the region in the low back with an injection. At times, laser therapy is given to patients to eliminate thick clusters of hair near the buttocks and prevent the recurrence of pilonidal cysts.

However, if the pilonidal cyst is severely infected, with abscess and sinus formations, then surgery is required to entirely eradicate the lump. Post operating the cyst, the surgeon chooses to either leave the wound open, which takes longer to heal, or closes the injured tissues with stitches to help it mend it faster. This ensures the pilonidal cyst is removed and relieves pain, discomfort in the patient.