Causes of a Pilonidal Cyst and How to Remove It

A pilonidal cyst is an unwanted growth at the end of the tailbone. Its unusual location, between the cleft of the buttocks, makes it an embarrassing condition. But the condition turns debilitating when the cyst becomes too big or gets infected. Of the numerous pilonidal cyst treatment options available, the colorectal surgeon will advise the most appropriate based on symptom acuity. But what causes a pilonidal cyst? Are there any ways to prevent it and what are the best ways to get rid of it permanently? Let’s find out:

Understanding Pilonidal Cyst

Like a pimple developing in a skin pore, the pilonidal cyst develops in a hair follicle. It accumulates skin debris and hair roots and gradually turns into a pus-filled sac.

The primary cause of pilonidal cysts is ingrowth of skin hair. Men are most likely to develop the condition because of their naturally hairy features. It typically occurs when the hair shaft fails to puncture the skin and grow outwards. Instead, it gets trapped under the skin, within the hair follicle. This causes inflammation and local soreness. If the cyst gets infected, it turns into a pilonidal disease.

What Triggers Pilonidal Cyst?

The root cause of pilonidal cysts is hair ingrowth and several factors contribute to it. These include:

Wearing Tight Clothes – People who prefer wearing tight-fitted clothes experience friction in the lower back area. This can cause the hair shaft to break. Also, insufficient space to grow outwards pushes the hair to grow inwards, leading to the formation of the cyst.

Prolonged Sitting Hours – Continuous pressure on the area due to prolonged sitting hours causes skin irritation. As a result, the skin in the sacrococcygeal area hardens, making it difficult for the hair shaft to pass through.

Texture Of Hair – People with hard and coarse hair are most prone to the condition. The coarse hair is curlier. The texture of the hair makes it difficult for the hair to puncture the skin layers. 

Hormonal Changes – Hormonal changes during puberty bring along a myriad of changes in the body. It increases hair growth and makes hair hard and thick, increasing the risk of developing pilonidal cysts.

Trauma – A lower back injury and subsequent coping surgeries can alter the key characteristics of the skin. It may cause the hair to embed, increasing the risk of developing pilonidal cysts.

Obesity – Body weight is one of the crucial factors that contributes to the increased risk of developing a pilonidal cyst. Excessive body weight leads to skin sagging that changes the structural qualities of the skin. This directly affects the hair follicles. Also, it increases friction and pressure that in turn predisposes the person to develop pilonidal cysts.

Poor Hygiene – Poor hygiene increases the risk of infection in the cyst. Inadequate cleaning of the area allows the bacterial infection to thrive. The pus-filled cyst is the most painful and difficult to treat, requiring extensive treatment for pilonidal cysts. 

Can Pilonidal Cysts Be Prevented?

Good lifestyle habits significantly reduce the risk of developing a pilonidal cyst in high-risk individuals. This includes maintaining proper hygiene, careful weight management by adopting healthy and active lifestyle habits, and frequent hair removal to keep the area neat.

But once they are formed, only a few cases of pilonidal cysts self-heal. Sitz bath and warm compress are the widely recommended home remedies for effective relief. But for severe cases where the cyst becomes infected or hinders day-to-day activities, taking proper care and going in for the most appropriate approaches available from pilonidal cyst treatments is the only way forward.

Treatment Pilonidal Cyst

A colorectal surgeon is trained and certified to handle pilonidal cysts. The treatment for pilonidal cysts ranges from incision and drainage to more invasive surgical procedures that involve complete removal of the cyst and the infected area.

Incision And Drainage

The treatment approach is always gradual with incision and drainage being the first-in-line of action. It involves cutting open the cyst and clearing off the accumulated debris and pus. Depending upon the size of the cyst and the severity of the symptoms, the doctor may consider leaving the wound open or closing it with sutures. Proper aftercare helps in quick healing and lowers the risk of relapse.

Surgical Removal

Unfortunately, the risk of recurrence in pilonidal cysts is high. The hard-to-treat cases with severe infection are treated the surgical way. It involves removing the cyst along with the surrounding skin. One of the most effective surgical procedures to remove pilonidal cysts permanently is the rhomboid flap technique. After removing the cyst, the surgeon fills up the wound cavity with a patch of healthy skin taken from another part of the body. The wound pouch is stitched with sutures. The healing phase is long until the grafted skin fuses with the surrounding skin. Antibiotics, painkillers, and comprehensive post-procedure guidelines are prescribed along with a schedule of follow-up check-ups.

Final Thoughts

From benign growth to being painful and inconvenient, a pilonidal cyst passes through different stages quickly. While understanding its causes and preventing it through lifestyle management is the best cure, seeking timely and appropriate treatment is important to manage the condition effectively and avoid complications.

If you or your loved one are suffering from a painful condition, seek help and guidance from an expert colorectal surgeon like Dr. Allen Kamrava MD MBA. A renowned and established colorectal surgeon in Beverly Hills, Dr. Kamrava has the expertise and experience to handle the most complex cases. Schedule an appointment today to discuss your case in particular.

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