What is Pilonidal Cyst?

A pilonidal cyst is an abnormal dimple in the skin containing debris of skin and hair, located at the top of the buttock cleft, near the tailbone.

According to Dr Purnendu Bhowmik, a pilonidal cyst specialist, pilonidal cysts most commonly occur in young men, and the disease tends to recur. Prolonged sitting increases the risk of developing the disease.


An infected pilonidal cyst shows the following symptoms:

  • Pain
  • Pus or blood drains from an opening in the skin
  • Reddening of the skin
  • Foul smell from draining pus
  • Fever


The exact cause of pilonidal cyst is unknown. However, according to Dr Purnendu Bhowmik, the best pilonidal cyst surgeon in Kolkata, a person generally develops a pilonidal cyst when hair penetrates through the skin and gets lodged inside. The person’s body responds to this hair as a foreign substance and creates a cyst around it. The cyst can then become infected and the resulting abscess often leads to extreme pain.

Risk Factors

The following factors stimulate the risk of developing a pilonidal cyst

  • Male sex
  • Younger age (pilonidal cysts most commonly occur in people in their 20s)
  • Obesity
  • Inactive lifestyle
  • Occupation requiring prolonged sitting
  • Excess body hair
  • Stiff or coarse hair


If left untreated, a chronically infected pilonidal cyst poses an increased risk of developing a type of skin cancer called squamous cell carcinoma.


A pilonidal cyst is a complicated disease that requires the attention of an experienced pilonidal cyst specialist. There are two types of treatment options for pilonidal cyst – non-surgical or conventional treatment and surgical treatments.

Non-surgical options can effectively treat pilonidal cysts. However, the recurrence rate is high in the case of these treatments, says Dr Purnendu Bhowmik, the best pilonidal cyst surgery doctor in Kolkata. The non-surgical options include antibiotics and removal of hair surrounding the cyst and washing the area with Hibiclens. Both of these options do not treat the underlying disease.

Non-surgical treatment might be helpful for some people; however, others will need to undergo surgery.

Surgical treatments for pilonidal cysts are of two types –

  • Wide excision of pilonidal sinus

This procedure includes a wide bore local excision of the skin containing the sinus tract. The cavity is left open to fill in naturally from the bottom upwards and heal. The wound is covered with a dressing.

This procedure takes up to 3 months of recovery, as the wound size is large. However, the surgery has a high chance of success with a 10-15% recurrence rate.

  • Laser Pilonidoplasty (LPP)

This procedure is minimally invasive. It is done using a laser to make a small cut on the skin and drain out all the pus. A laser fibre is then used to seal the sinus tract. Compared to wide excision surgery, laser surgery requires little recovery time. After the surgery, patients are discharged within 24 hours and can return to routine work by the 5th day. The recurrence rate is also negligible in the case of laser surgery.