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Pilonidal Cyst

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Medical Treatment for a Pilonidal Cyst

Antibiotics do not heal a pilonidal cyst. Doctors have any of a number of procedures available, including the following treatments.

  • The preferred technique for a first pilonidal cyst is incision and drainage of the cyst, removing the hair follicles and packing the cavity with gauze.
    • Advantage -- Simple procedure done under local anesthesia
    • Disadvantage -- Frequent changing of gauze packing until the cyst heals, sometimes up to three weeks
  • Marsupialization -- This procedure involves incision and draining, removal of pus and hair, and sewing of the edges of the fibrous tract to the wound edges to make a pouch.
    • Advantages -- Outpatient surgery under local anesthesia, minimizes the size and depth of the wound without the need to pack gauze in the wound
    • Disadvantages -- Requires about six weeks to heal, needs a doctor trained in the technique
  • Another option is incision and drainage with immediate closing of the wound.
    • Advantages -- Wound completely closed immediately following surgery without need for gauze
    • Disadvantages -- High rate of recurrence (it is hard to remove the entire cyst, which might come back). Typically performed in an operating room, it requires a specially trained surgeon.

Pilonidal Cyst Follow-Up

After surgery to drain a pilonidal cyst, follow-up includes:

  • Keeping the wound clean and covered while it heals. Wash around the area at least once a day.
  • The doctor will want to look at the wound frequently to be sure it is healing.
  • Consulting the doctor at once if it appears the cyst is returning.

Pilonidal Cyst Outlook

A complete cure is possible, but a pilonidal cyst may recur -- even if surgically removed.

WebMD Medical Reference

Reviewed by Debra Jaliman, MD on November 02, 2013
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