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What the Heck Is a Pilonidal Cyst? My Son's Story

I had not heard of pilonidal cysts before my 18-year-old son developed one. I want to share his experience and how he got it removed.

A pilonidal cyst forms most commonly on the tailbone area—at or near the top of the cleft of the buttocks. I don't believe I have ever seen anything quite like it. Most doctors believe that it is caused by an ingrown hair that then becomes infected. Some doctors think a pilonidal cyst is a remnant of the human tail seen during fetal development. This "tail" is supposed disappear once the spine is done developing, but sometimes, it doesn't and can develop into this painful bump. Another theory is that some sort of injury of the sacrococcygeal (tailbone) area can cause these cysts to occur. The causes are still being looked at.

Pilonidal cysts are more often seen in men than in women. Usually, they show up between the ages of 15 and 24 with very rare occurrences after the age of 40.

Symptoms

My son started to complain about his buttocks hurting so I told him he probably had a pimple or something, and it would go away. I hadn't looked because I don't regularly look at my 18-year-old son's buttocks—haven't seen it since he was six or so. After a week went by, he woke up with blood and pus everywhere—I had to take a look. What I saw stunned me. I don't think I can really explain my thoughts as to what I was looking at. After I got it cleaned up, I was met with the most shocking thing I do believe I have ever seen, and I don't mean in pictures. This was real life.

My son had two small holes in his skin. There was no flesh of any kind within the holes. And they were deep. My jaws dropped, and I think I muttered, "Oh my God." I was looking into darkness, which I later learned was a cavity left by the cyst. I need to say it again: "Oh my God." Many thoughts ran through my mind; among them—flesh-eating virus. Now my heart was pounding and my stomach was lurching.

If any of this is vaguely familiar to you, you may have a pilonidal cyst. Here are some more symptoms to look for:

  • Pain
  • Localized swelling
  • Reddening of the skin
  • Drainage of pus and blood from an opening of the skin called a pilonidal sinus
  • Hair protruding from the area
  • Fever (although it's rare)
  • Foul smell from the draining pus

The pilonidal sinus looks like a channel or tunnel below the surface of the skin that connects the root of the cyst to the opening on the surface of the skin.

Risk Factors

Some doctors believe the likelihood of developing a pilonidal cyst increases with long periods of sitting or sitting improperly as well as poor hygiene.

Mayo Clinic gives these risk factors:

  • Obesity
  • Inactive lifestyle
  • Occupation or sports that require sitting
  • Excess body hair
  • Stiff, coarse, ingrown hair
  • Poor hygiene
  • Excess sweating

My son had a few of these—excessive sitting, excess body hair (he is a hairy guy), and stiff or coarse hair. So do I think his human tail didn't absorb during gestation, or do I think he just plays too many video games sitting on his butt? Well, he does play and sit on his butt too much, like most teenagers these days. Do I think that's the cause? I just don't know. What I do know is that it must be fixed. My son is having pain, and I don't care for that.

Treatments

The first thing to know is that antibiotics will not completely heal a pilonidal cyst—it will only treat the infection. Once a cavity is opened, it will not close again without some type of medical intervention. At least that is how I interpret the information I have been poring over since my son saw the doctor.

One treatment option is incision and drainage. The tailbone area is numbed with a local anesthetic, and the doctor makes an incision to drain and clean the cyst. The wound is then packed with dressing so it can heal from the inside out.

Another option is surgery. This procedure is necessary if the cyst is recurring or you have one or more of the sinus passages open.

All your options should be discussed with your doctor to find out which treatment is the right one for you. Postoperative care is equally important, and you will have detailed instructions from your doctor regarding proper care.

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Preventions

Mayo Clinic offers these tips on helping prevent the recurrence of a pilonidal cyst.

  • Remove any hair from this area on a regular basis. Shaving or depilatory creams work well in this area. Laser treatments for hair growth may also help.
  • Clean the area daily with glycerin soap because it's less irritating to the skin. Rinse all soap residue off the area. Once the area is healed and no longer sore, washing the area briskly with a washcloth also helps keep the area free of hair.
  • Keep the area clean and dry. Don't use powders, oils, or herbal remedies in this area.
  • Avoid sitting for long periods of time.

I will certainly be hounding my kid to get off his butt more often. Although with the pain he is in, I do believe he will do anything to prevent this from happening again.

It Was Surgically Removed

My son has been on his antibiotic for a day and a half, and already, his infection looks like it's healing. He is on some strong antibiotic, taking 875 mg twice a day. When he was done with this course of antibiotics, he went into surgery to have the cyst removed. I am happy to say that after more than five years, he has not had another cyst.

I hope this has helped others who are experiencing something going on in the "behind" region. I had never heard of pilonidal cysts before and found it most interesting, so I wanted to pass it along.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

Comments

fishtiger58 (author) from Momence, Illinois on August 19, 2018:

Hi Linda, Yea I have no idea about how long they can stay buried. It's a very good question that I hadn't thought about. My son is now 27 and so far so good, no recurrence luckily for him. Many people have them occur over and over again. I think my son has dodged a bullet. Much good luck to you tomorrow.

Linda Steininger from Plymouth, Indiana on August 19, 2018:

Hello, Fishtiger58! I just started my first search for answers to my sore swollen tail bone, and your story popped up. I love the way so many others tell their “tales”, too! I am a bit different, so this may not be my problem. I will be seeing my GP tomorrow and see what he thinks.

I have been having trouble with pain and finding a comfy sitting position for years, when I weighed 263 or now at 163 & 5’8”. I have always blamed it on not having any “meat” on my butt, just sitting on my butt bones. My difference? I am a 73 year old female. Not hairy. Not ever fat in the butt area. But, have always preferred pastimes where I’m seated.

I’m wondering how long these cysts can stay burried before they rear their ugly heads?!! I guess I’ll find out tomorrow!

I certainly hope everybody has healed up nicely......

fishtiger58 (author) from Momence, Illinois on August 02, 2016:

Alex I think you should tell your mom and dad and have it checked out. Suze46 I wouldn't wait any longer I believe the longer you wait the worse it can get. Go see your doc and get it fixed.

suze46 on August 01, 2016:

So I have had the 3 little holes since 14 or 15 yrs old. My dad had surgery & a brother had a cyst. I thought all people came w/the little holes & never told anyone. Always have had trouble sitting & took a job where I was on my feet mostly. I am 56, female &have been biking alot. No drainage ever, just pain & cant sit for long time. Should I ask my primary care doc? Or wait til itx unbearable? Thanks

StellarTutor on May 01, 2016:

Alex, I was just 16 when I developed a pilonidal cyst and it was AWFUL! I am an American but went to New Zealand as an exchange student from California. It was in NZ that it was originally misdiagnosed as a bruised tailbone and the "therapy" made it much worse and much more painful until I had to go in for emergency surgery. It IS SURMOUNTABLE! I truly believe I am a better, stronger person with much more character than I would have had not going through this experience. I hope you are better by now. I see your post is six months old. I am presently suffering from another pilonidal cyst that requires surgery and I am now 45. 29 years cyst free was awesome. Don't feel like a freak or anything because you are female and not some big hairy dude. Hang in there.

Alex on October 31, 2015:

I'm 13 and a girl, and I think I might have the same thing. About two weeks ago, I noticed that a black hole had formed at the top of my butt. Occasionally there would be some pus. There wasn't really any pain. I didn't really think anything of it, and just left it alone and hoped that it would go away. Today, I noticed another, slightly smaller hole just beneath the first one. I don't know what to do, and I'm really really scared!!

fishtiger58 (author) from Momence, Illinois on November 23, 2014:

You are so welcome Another Mom, my son had his surgery when he was 18, he is now 23 1/2 and still no recurrence of his cyst thankfully. At one point we thought he was getting another but then it went away and nothing since. Much much good luck to your son. I hope everything goes well.

Another mom on November 23, 2014:

My 16 year old son came to me last night asking if I would look at his butt. I knew right away something was wrong. That's a question I know he would never ask. I found 8 small holes and 1 large hole. I pulled groups of hair out of each hole. Some were at least 2 inches long. My boy is a hairy guy too. I've already contacted his doctor. He started antibiotics today and will see doc in the morning. I already know this is exactly what he has and he will have to have ten removed because I had the same thing at 17. I'm so sad that he will have to endure this but we will all face it together. Thanks for your sons story! It's always nice to know your not alone.

fishtiger58 (author) from Momence, Illinois on November 01, 2014:

wow you doctor should know if it's a pilonidal cyst or not. If it doesn't improve after the antibiotics I would ask her if it is in fact a pilonidal cyst. Much good luck to you Improvingmylife.

Improvingmylife on November 01, 2014:

Hi,

I'm a 23 year old female. Last week I began feeling a burning sensation on my tailbone. It hurt so bad I had to go to the doctor. He gave me some painkillers to relief the pain. The painkillers helped only for a few hours. In the weekend I noticed a little red bump. Which scared me. I thought immediately that it was a cold sore. I'm still in doubt if I have genital herpes. Even though I've been tested negative. I've had a few 'cold sores' on my lip and vaginal area throughout this year. Which is why I'm doubting my test results. Anyways over the past few days the sore has gotten redder and bigger. I've been to the doctor again and was prescribed antibiotics. The wound hasn't gotten bigger since I'm taking my antibiotics, but the pain has gotten worse. I don't know if this is the antibiotics doing it's work. But I've noticed the sore has gotten white, it really looks like a cold sore. But around the sore has a reddish/purplish color. Also my butt cheeks around the sore has gotten hard as rock. I also feel as if someone's stabbing me every few seconds in my butt. My doctor said that I should come back after I've finished my antibiotics and I've seen no positive results. She also told me that I can go to the emergency room if I want to and maybe they'll cut out the affected area. This morning I've noticed a lil drop of dry blood at the hole. I'm tempted to squeeze the sore, but I'm too scared of the pain and that I might make the infection worse. At the emergency room they gave me painkillers and said that they'll only remove the affected area with a letter from my doctor. But my doctor doesn't wants to write a letter in order for them to remove the affected area, cause according to her the sore isn't ripe enough. I'm really in so much pain and wished the medical care would at least help me. I hope it's the pilonidal cyst I have and not a cold sore. I know the feeling your son has been through, a painful experience and yet affects my self esteem as my sexual life. I would never wish this on any of my enemies. Thanks for sharing your story.

fishtiger58 (author) from Momence, Illinois on October 05, 2014:

I'm not a doctor but it won't heal. Go see a doctor it's really your only option. Much good luck to you.

Please help! on October 05, 2014:

I've had this condition for about a month now and now it is oozing and smelling God awful like something rotting, I take showers everyday and after using the bathroom, it sometimes bleeds but not much. I do believe I have a cyst as well but embarrassed to tell my parents not sure how I can cure it or get it to heal, please help! I've read some other articles saying that it may be cancer or some other bad stuff, I'm really worried, if I can get it to heal without going to the doctor would be awesome but right now I'm really nervous and worried about this, Im in college now and most of my time is sitting down so I don't know how to get around that. But if any of you guys can give me some guidance that would be great, however if must call for it, I'm willing to tell my parents because I'm so over the pain and discomfort trying to sit and go through the day like this! Please help!!!

fishtiger58 (author) from Momence, Illinois on February 17, 2014:

see my comment below

fishtiger58 (author) from Momence, Illinois on February 17, 2014:

Hi Grossedout, it sounds like it, but I'm not a doctor. I would suggest he see a doctor. Thanks for reading my hub

Grossedout on February 16, 2014:

Hi,

I'm not sure if this is the same thing, but yesterday I noticed 5 small black holes on my boyfriends tail bone area on the top and they had little hairs sticking out. I removed the hair and was grossed out by how long and how much there was. I'm wondering is this how the cyst start?

fishtiger58 (author) from Momence, Illinois on December 01, 2013:

I have heard of the polonidal dimple but have never heard of it oozing stuff. Very interesting. As for the Epsom salt I would do some research on that to see if it helps. Much good luck to you curtisbunheirao I hope everything turns out well for you, I wouldn't wish this mess on anyone.

curtisbunheirao on December 01, 2013:

hi fishtiger, about 2-3 years ago, i found that i had a second hole top of my buttcrack!...sometimes it itches and sometimes it feels sore but those symptoms comes and goes and just lately have i noticed that its secreting some sort of white ooze and in which it does not have an odor to it...i went to see the doctor as soon as i found this hole...doctor told me that its a pilonidal dimple and that its hereditary, and should not need anything done unless it gets infected, to just keep it clean. and that was it....so after reading all the above comments..im terrified!..i do not want to or have to go through anything as far as lancing and draining , nor surgery... so for now im just gonna keep up a daily prevention, by removing surrounding hairs and keeping it clean, and hope that by the time i hit the age 40 i wont have to endure this any longer ... im 31 now. ..hmm i wonder if a cyst bath ( Epsom Salt and hot water) would be beneficial...

fishtiger58 (author) from Momence, Illinois on October 19, 2013:

My son had the closed wound surgery and he was good in about 2 weeks, then we thought it was coming back about a year later but thankfully he is still cyst free. I am so sorry for you mark.