Infected Pilonidal Cyst (Incision & Drainage)

Cause

The cause of pilonidal cysts has been debated since they were first recognized. It may be present at birth and go unnoticed. Injury, rubbing, or skin irritation may also cause pilonidal cysts. It can be caused by an ingrown hair. Most likely, the cause is a combination of these things. Because some injury or irritation can lead to pilonidal cysts, it can be more common in people who sit or drive a lot for work. Pilonidal cysts are more common in young men. People who sit for long periods of time, such as truck drivers, are more prone to get them. The condition also is common in barbers and dog groomers who work around hair. People with a lot of body hair, are overweight, or don’t exercise much also are at higher risk for these cysts.

Symptoms

A pilonidal cyst may be small and painless. If it's inflamed or infected, you may have these symptoms:

• Swelling

• Irritation or redness

• Pain

• Drainage

The cyst can swell and drain on its own. The swelling and drainage can come and go.

Treatment

Your pilonidal cyst was drained with a small incision using local anesthesia.

After the incision and drainage, gauze packing may be inserted into the opening. If so, it should be removed in 1 to 2 days, or as advised. Antibiotics may not be needed to treat a simple abscess, unless the infection spreads into the skin around the wound. The wound will take about 1 to 2 weeks to heal depending on the size of the cyst.

Home care

Wound care

• Pus may drain from the wound for the first few days. Cover the wound with a clean dry bandage. Change the bandage if it becomes soaked with blood or pus, or if it gets soiled with feces or urine.

• If gauze packing was placed inside the cyst cavity, you may be told to remove it yourself. You may do this in the shower. Once the packing is removed, you should wash the area carefully in the shower once a day. Do this until the skin opening has closed. It's OK to point the shower spray directly into the opening if this is not too painful.

• Be sure to carefully discard the bandages or packing to prevent spreading infection.

Medicines

• Take acetaminophen or ibuprofen for pain, unless you were given a different pain medicine to use. Talk with your doctor before using these medicines if you have chronic liver or kidney disease or have ever had a stomach ulcer or digestive bleeding. Also talk with your doctor if you're taking blood-thinner medicines.

• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

• Use antibiotic cream or ointment if your doctor tells you to do so.

Prevention

Once this infection has healed, the following may decrease the risk of future infections:

• Keep the area of the cyst clean by bathing or showering daily.

• Don't wear tight-fitting clothing. This can reduce perspiration and irritation of the skin.

• Pilonidal cysts that come back may be completely removed by surgery. But this can be done only at a time when there is no infection. Ask your doctor for more information.

Follow-up care

Follow up with your doctor as advised. If a gauze packing was inserted in your wound, it should be removed in 1 to 2 days, or as directed. Check your wound every day for the signs of infection listed below.

When to get medical advice

Call your doctor right away if:

• Pus continues to come from the cyst for 5 days after the incision.

• You have increasing redness, local pain, or swelling.

• You have a fever of 100.4°F (38°C) or higher, or as advised by your doctor.