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Pilonidal Cyst, Infected (Antibiotic Treatment)

A pilonidal cyst is a swelling that starts under the skin on the sacrum near the tail bone. It is present at birth and may look like a small dimple. It can fill with skin oils, hair, and dead skin cells, and may stay small or grow larger. Because it often has an opening to the surface, it may become infected with normal skin bacteria. A pilonidal cyst is different than a hemorrhoid.

Causes

The cause of pilonidal cysts has been debated since they were first recognized. It may be present at birth and go unnoticed. It may appear like a small dimple. Injury, rubbing, or skin irritation may also cause pilonidal cysts. It can also 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.

Symptoms

A pilonidal cyst may be small and painless. If symptoms occur, they may include:

  • Swelling

  • Irritation or redness

  • Pain

  • Drainage

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

Treatment

If the infection is limited, it can possibly be treated with antibiotics alone. If the infection is more severe or gets worse, it will need to be drained. Often this can be done with a small incision under local anesthesia, but may need surgery to treat it or prevent it from returning.

Home care

The following guidelines will help you care for your wound at home:

  • Sit in a tub filled with about 6 inches of hot water. Keep the water hot for a total of 10 to 15 minutes. 

  • Do not squeeze the pilonidal cyst or stick a need to drain it. It may feel better at first, but it will make the infection worse, or spread it.

  • Cover the cyst with a pad or something to prevent it from becoming more irritated, damaged, and painful.

Medications

  • Take acetaminophen or ibuprofen for pain, unless you were given a different pain medicine to use. If you have chronic liver or kidney disease, or have ever had a stomach ulcer or gastrointestinal bleeding, or are taking blood thinner medications, talk with your doctor before using these medicines.

  • If you were given antibiotics, take them until they are all gone. To make sure the infection is cured, it is important to finish the antibiotics even if the wound looks better.

  • Use antibiotic cream or ointment.  

Preventing future infections

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.

  • Avoid tight-fitting clothing to minimize sweat and irritation of the skin.

  • Recurrent pilonidal cysts may be completely removed by surgery, but this can only be done at a time when there is no infection. Ask your doctor for more information.

  • Watch for signs of infection listed below so that treatment may be started early.

Follow-up care

Follow up with your doctor as advised by our staff. Check your wound every day for the signs listed below.

When to seek medical care

Get prompt medical attention if any of the following occur:

  • Pus coming from the cyst

  • Increasing local pain, redness or swelling

  • Fever over 100.4°F (38.0°C) for more than two days

 

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