If you've developed a painful spot at the base of your spine, you may have an infected pilonidal cyst. You may be experiencing pain that gets worse when you're sitting or laying down. You might even have pus draining from it, which can be embarrassing as well.
Pilonidal cysts are very normal. And will affect almost 5% of all people. But if left untreated, the infection will spread and become even more uncomfortable.
Diagnosis and Treatment at UVA Health
Your provider will take a look at the area and assess what stage it is in. There are three possible stages:
- Cyst - Cysts can cause irritated skin and localized pain. But they are not infected.
- Abscess - An abscess is infected. You may have a fever or chills. There will also be pus under the skin.
- Sinus - An opening at the top of the buttocks.
Treatment will depend on your pilonidal defect's stage and your level of comfort.
Incision and Drainage
For immediate relief, your doctor may offer a lancing. A numbing agent is applied, and then the area is lanced so the pus can be drained. Then, the wound will be packed with sterile gauze. While very helpful, this doesn't actually cure the issue permanently.
If this is a recurring issue or the infection has spread, your doctor will talk to you about surgery.
Surgery for Pilonidal Cysts
The only true cure for this condition is surgery. An excision removes all affected tissue. This prevents it from coming back. Though more extensive, for many this is the better option.
What causes pilonidal cysts?
Some people are born with a pilonidal cyst. Congenital pilonidal cysts are there from birth. The defect allows an infection to develop. For others, the infection is caused by an enlarged hair follicle. Because men tend to have more lower back hair than women, this condition is more common in men.
Other factors that increase your risk include:
- Family history of cysts
- Having a lot of lower back hair
- Injuring your tailbone
- Long periods of sitting (including horseback riding and biking)
Can a pilonidal cysts be prevented?
Pilonidal cysts can't always be avoided. But keeping your skin clean and dry can help. You can also:
- Make sure your seats are cushioned
- Remove hair regularly
There are even some studies that show laser hair removal can help prevent pilonidal cysts from recurring.
Can I treat a pilonidal cyst at home?
Not permanently. Excision is the only permanent solution. But if you're in pain, using a warm water compress can help draw out the infection.