Can Pilonidal Cysts Self-Heal?

The growth of pilonidal cysts is a common condition with more than 70,000 cases reported in the US every year. But due to its embarrassing site of occurrence, doctors feel that many more cases go unreported. While pilonidal cyst excision is touted as the best treatment approach, one still wonders whether pilonidal cysts are self-limiting and go away on their own. Let’s understand pilonidal cysts better:

What Is A Pilonidal Cyst?

Just like any other cyst, a pilonidal cyst is a growth at the end of the tailbone, also known as the coccyx area. It resembles a large pimple that is triggered due to ingrown hair. The accumulation of hair and skin debris under the skin makes the site infected. Depending upon the number of hair follicles involved, there can be one or more cysts in a particular area. The presence of pus turns it into a painful abscess that makes everyday activities difficult.

Common Causes Of Pilonidal Cyst

A pilonidal cyst is marked by ingrown hair. But what causes the ingrowth between the cheeks of the buttocks? Listed below are the most likely reasons:

• Prolonged Sitting – Extended sitting hours exert pressure on the area causing the hair follicles to break. Once the hair follicles get blocked, it increases the risk of infection and turns it into a pilonidal cyst.
• Wearing Tight Clothing – Wearing tight clothing increases friction and constant irritation in the area. This contributes to the development of cysts.
• Excessive Hair Growth And Hair Quality– Some people are naturally more hairy. Also, people with coarse hair are more prone to pilonidal cysts. The roots of coarse and thick hair penetrate deeper into the skin layers, increasing the risk of hair follicle blockage. 
• Overweight – Obese individuals have more skin flab in the affected area.  This creates more pressure and friction between the skin folds and increases the risk of developing pilonidal cysts. 

Symptoms Of Pilonidal Cyst

As the growth of a pilonidal cyst is on the rare side of the body, the symptoms are primarily felt. The telltale symptoms of pilonidal cyst are:

• Pain – Lower back pain, especially when sitting, standing, or walking. 
• Swelling – Localized swelling and the affected area is tender to touch. 
• Drainage – Pilonidal cysts that get infected ooze out pus. The discharge can be foul-smelling and yellowish-green in color. 
• Fever – In cases of severe infection, fever along with other signs of infection may set in. 

Is Pilonidal Cyst Self-Healing?

As small cysts tend to heal on their own, many people believe that these too can settle without medical intervention. However, experts in the field who perform excision of pilonidal cysts highlight that this is only a rare scenario. Many factors play a role. These include:

• Severity Of Condition – Mild cases, especially when the cyst is small and not causing much pain or discomfort, may self-heal. However proper hygiene and self-care are crucial for stimulating natural healing. 
• Chronic Episodes – Chances are that acute cases of pilonidal cysts settle and do not occur again. However, people diagnosed with chronic pilonidal disease are prone to recurrent outbursts. Excision pilonidal cyst is thus the typically required treatment approach. 
• Lifestyle Factors – Lifestyle habits play a major role in determining whether a pilonidal cyst can self-heal. Weight control, a good exercise regimen, maintaining good hygiene, and wearing easy-fitting clothing can help heal mild cases. 

When To Consult A Doctor?

Pilonidal cysts can turn bad to worse in no time. If you experience any of the symptoms of pilonidal cysts is a good idea to have the issue medically investigated. A pilonidal cyst diagnosis typically involves a physical examination. The doctor will assess the area in between the crease of the buttocks to check for signs of redness, swelling, or any kind of fluid drainage. 

Pilonidal Cyst – Treatment Plan 

Most cases of pilonidal cysts settle after pilonidal cyst excision. This involves cutting open the cyst and graining out the debris and accumulation. Antibiotics are subsequently prescribed for proper internal healing and eliminating any risk of infection. 

But for cases where a pilonidal cyst is chronic and recurrent, pilonidal cyst excision surgery is the highly advocated treatment method. It is also necessary in cases wherein the cyst worsens and creates a hole under the skin. The rhomboid flap technique is one of the promising treatment methods that removes a portion of the infected skin with a specific type of excision. A healthy skin patch is then grafted at the site to prevent any kind of recurrence and relapse of pilonidal cysts. 

How Long Is The Recovery Period?

A typical case of pilonidal cyst takes anywhere between a few days to up to 6 weeks to heal completely. In cases where extensive pilonidal cyst excision surgery is performed, the healing period may be several months.

Final Thoughts

Pilonidal cysts are more likely to be benign growths in the hair follicles. These are self-limiting and self-healing. However, it is advisable to consult a doctor as untreated pilonidal cysts can trigger systemic infection in the body. Also, although rare, pilonidal cysts can develop into squamous cell carcinoma, a type of skin cancer. If you are experiencing any signs or symptoms of pilonidal cysts, it’s best to consult the expert Allen Kamrava MD MBA. With years of experience and the right wherewithal, you can be sure of the best guidance and treatment to get rid of pilonidal cysts.