Pilonidal Abscess

Pilonidal abscess is an infection, which occurs in cyst at the pilonidal part of the body. Pilonidal is an area located beneath the tailbone. This area is specifically located under the tailbone and at the top part of the cleft in buttocks. This area is covered with hair and at time because of its location, it collects debris. A pocket sometimes is formed in the skin around the pilonidal area developing into a cyst. When the cyst is infected, it can swell and build up pus.

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Although pilonidal cyst is mainly harmless, and may not need treatment, if it is infected, it can cause troubles. An infected pilonidal cyst or pocket leads to a condition known as pilonidal abscess. This condition requires treatment in order to get rid of the infection. The abscess can occur at one time or it can be recurring meaning that it comes and goes. When a person has pilonidal abscess, it may go away itself or it may have to be treated and drained. Pilonidal abscesses appear like large pimple in the area at the bottom of tailbone.


There are different aspects that may cause pilonidal abscess and one is ingrown hair. Ingrown hairs occur when hair curls around and grows back to the skin. The hair does not grow upwards as it is supposed to and instead it grows inside the skin. Another possible cause is excessive sitting, which increases pressure on coccyx area.

Although trauma or injury is not believed to cause the pilonidal cyst, such events can lead to inflammation of an already existing pilonidal cyst. Excessive sweating may lead to pilonidal abscess. When moisture fills a stretched hair follicle, it can lead to low oxygen environment that enhances growth of anaerobic bacteria. The presence of such bacteria coupled with the low oxygen may impair wound healing and increase the chances of formation of pilonidal cyst. This condition is common in young people and rarely affects people over 40 years. Men are more likely to suffer the infection than women are.


A pilonidal cyst or pilonidal abscess may have symptoms like pain at the bottom of the spine. The pain is caused by swelling that occurs in the same area. The infected area becomes red and drains pus. A person may also have fever. If you have any of these symptoms, you need to consult your doctor. Some people do not show symptoms of this condition however, those who develop symptoms, they include occasional pus, which accumulates in the cyst, or pocket.

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To diagnose pilonidal cyst, a doctor may gather information about your past medical history. The doctor may ask questions on symptoms you have had regarding the cyst. A physical exam is performed by the doctor to determine the tenderness, redness, and swelling of the affected area especially the region between the buttocks and cheeks above the anus. Physical examination may also check on fever and increased white blood cells through blood sample, although this is not always taken. Inflammation of the surrounding skin is also examined.

Treatment of pilonidal abscess

Patients who suffer from acute pilonidal abscess need to get treatment for the condition. A doctor may use incision procedure to remove the pus. A local anesthesia is applied to numb the affected area. An incision is performed to drain of pus that has accumulated on the pocket. Such draining of pus relieves the pressure created and decreases pain. A patient needs to ensure the area is cleansed properly in order to keep debris and hair away from the wound.

A follow up is needed to ensure the wound heals. The healing of the wound can occur within a few weeks. If the abscess continues to recur, a surgery may be required to open, clean, and stitch the cyst. Wound hygiene is very important when treating this condition to ensure that no re-infection occurs. The area has to be cleansed and dressed properly to prevent premature closure of skin or a re-infection as these problems can occur after a surgery has been done.

Marsupialization is a procedure, which involves the use of incision to drain and remove pus and debris such as hair that may be present in the cyst. The area is sewed on the edges of fibrous tract and the wound edges to create a pouch. Although antibiotics do not heal cyst, use of these antibiotics may be recommended to help treat the bacterial infection.

Hot compresses and use of depilatory creams are other ways that can be used to treat this condition. There are home remedies that may help in relieving the symptoms like redness and swelling as well as pain. Sitting on warm tub can decrease the pain and reduce the chances of the cyst developing to a level where it requires incision and drainage.

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