Introduction
A pilonidal cyst, also known as a pilonidal sinus or sacral abscess, is a painful and potentially chronic inflammatory condition affecting the coccyx (tailbone) area. It is characterized by the formation of a small cyst or abscess that often contains trapped hairs and debris. If untreated, it may become recurrent or chronic.
Causes and Risk Factors
- Excessive hair growth: Common in people with dense hair near the coccyx.
- Prolonged sitting: Increases pressure and friction on the coccygeal area.
- Friction from tight clothing: Irritates the skin and encourages cyst development.
- Obesity: Adds pressure and friction in the affected region.
- Family history: Suggests a genetic predisposition.
- Hidradenitis suppurativa & Smoking: Inflammation and poor tissue healing raise risks significantly.
Symptoms
- Tenderness or pain near the tailbone
- Swelling or lump at the top of the buttock cleft
- Redness or pus discharge (often foul-smelling)
- Pain when sitting or standing
- Fever or malaise if infected
Diagnosis
Diagnosis is usually clinical. If needed, ultrasound can assess cyst size and complexity. MRI or CT may be used in more complex cases.
Treatment Options
- Conservative Management
• Warm compresses, hygiene, antibiotic ointments
• Laser hair removal to prevent recurrence - Minimally Invasive Procedures
• Phenol injections
• Laser therapy (CO2, SiLaC)
• EPSIT (Endoscopic treatment) - Surgery
• Open or closed excision for complex/recurrent cases
Laser Therapy
Laser ablation offers a precise, less invasive solution with faster recovery and minimal discomfort. It targets trapped hairs, reduces inflammation, and promotes collagen remodeling.
EPSIT (Endoscopic Pilonidal Sinus Treatment)
EPSIT uses an endoscope to clean and remove debris and hairs from inside the cyst. It’s minimally invasive, performed under local anesthesia, and yields excellent cosmetic and healing results.
Imaging and Follow-Up
Ultrasound is essential both for diagnosis and post-treatment monitoring. It ensures all hair is removed and healing is complete, guiding personalized follow-up care.
Prevention
- Maintain hygiene and dry skin
- Use antibacterial soap
- Regular laser hair removal
- Avoid prolonged sitting
- Keep a healthy weight and wear breathable clothes
Conclusion
Timely diagnosis and appropriate treatment—especially laser or EPSIT—can significantly improve outcomes and prevent recurrences. Trust experienced specialists for optimal care.
