What causes a pilonidal cyst?

There are some theories about the cause of these odd infections, but in cases, it is hard to explain why a given individual gets one. In some cases, there is an ingrowth of hair across the deep cleft between the buttocks. The hair seems to actually grow outward from one side, and into the skin on the other side. The hairs can then continue growing, curling up into a tight ball of hair and debris, until an infection develops. In other cases there is no hair ingrowth and the cause is not clear.

I had to have a pilonidal cyst drained. The pain is gone, but there is still a little drainage. Should anything be done about this?

Pilonidal cysts frequently recur, though they may not cause any problems for years after the initial infection. Surgery can be done to remove the remaining cyst though this may not be appropriate to do after the first episode of infection.

The surgical procedure involves the removal of much of the fatty tissue in the area where the infection developed. The skin and surrounding tissue is sewn back together to close the defect. There is a possibility that an infection will occur shortly after the surgery, and this can require that the surgical incision be re-opened. Although the incision will ultimately heal even in this case, the incision will require daily care with cleansing and dressings for several weeks. Problems such as this occur in 15-20% of the cases.

Since there is a rather high infection risk, a non-surgical approach may be considered after the first episode, reserving surgery for recurrent cases. The area must be kept meticulously clean. The hair in the cleft should be shaved regularly to prevent growth across the cleft. Any pain or drainage should be promptly reported to your surgeon, so that immediate intervention can be made.