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A pilonidal cyst (sacrococcygeal fistula) is an abnormal pocket in the skin that usually locates itself above the buttocks near the tailbone. The cyst looks much like a pimple and commonly contains hair and skin debris. If the cyst becomes infected it can result in a really painful abscess that requires clinical attention.


Pilonidal cysts were first described in 1833 by Herbert Mayo. The term pilonidal is derived from the Latin words “pilus” (hair) and “nidus” (nest). While pilonidal cysts occur more frequently in men than in women, they are also more common in people of Middle Eastern and Caucasian descent than in other racial groups.

  • Symptoms of pilonidal cysts include pain, swelling and/or redness at the bottom of the spine

  • Fever, drainage of pus or blood from an opening in the skin (usually with an odor).

Treatment of Pilonidal Disease

In many cases pilonidal disease can be easily treated by keeping the affected area clean and using antibacterial soap. In some cases, antibiotics may be needed to help control the infection. For recurring abscesses, or for very severe infections, the cyst must be opened and drained surgically.


There are two types of surgical procedures available to treat pilonidal disease; incision and drainage or complete excision of the cyst. Treatment for this condition varies on a case by case basis and is dependent on the severity of the infection. An exam of the infected area should be done before determining which form of treatment is best for you.

Incision and Drainage:

The main technique for treating an infected pilonidal abscess is lancing the cyst and draining the pus within it. This is typically a simple procedure performed in office under a local anesthetic.



Should an excision of the abscess be necessary, the area will be surgically opened and a complete debridement will be performed. This technique is often favored by physicians because there is a decreased risk in wound complications. Since the wound is being left open to heal, there is little risk of an actual wound infection.


A more advanced technique is complete cyst excision using rotational skin flaps for the closure of the wound. These techniques allow for complete cyst excision followed by closure using a patient’s tissue. Although this technique can be technically more challenging, the outcomes for these pilonidal cyst treatments have demonstrated the shortest recoveries with the lowest recurrence and wound infection rates.

If you are experiencing pain due to pilonidal disease, you should contact our office for an immediate evaluation. Our state-of-the-art facility provides the highest quality treatment for patients. We have a team of world-class surgeons, led by Dr. Yosef Nasseri and Dr. Moshe Barnajian. Combined our team of physicians has over 30 years of experience in treating patients with this common ailment, so you can rest assured that you are in the best hands possible.

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