Pilonidal Cysts: How Serious Are They?

Pilonidal cysts are infected pus-filled sacs or skin pockets near the tailbone at the buttocks’ top. An abscess or infection occurs when debris, such as hair, dead skin cells, or other debris, becomes trapped in the pocket. Women are less likely to suffer from this pilonidal cyst condition than men, which can cause pain, redness, swelling, and bleeding. 

It is possible to develop a pilonidal sinus if the cyst is left untreated and does not receive treatment. A pilonidal sinus is a tunnel connecting the cyst to the skin’s surface. A cyst may need draining and settled with prescribed antibiotics, or one may need to consider pilonidal cyst removal surgery.

Pilonidal cysts: Risk factors

Pilonidal cysts are more likely to develop when there are several risk factors. The following are among them:

  • Being male

Men are more likely than women to develop pilonidal cysts.

  • Age

Young adults between the ages of 15 and 24 are more likely to suffer from the condition.

  • Family history

There is an increased risk of developing a pilonidal cyst or sinuses if there is a family history of them.

  • Obesity

The pilonidal disease is more likely to develop in overweight or obese individuals.

  • Sedentary lifestyle

In addition to prolonged sitting and driving, sedentary lifestyles may increase the risk of pilonidal cysts.

  • Hairy back

Cysts can grow in the area around the tailbone if there is excessive hair growth in the area.

  • Trauma

It is also possible for pilonidal cysts to develop after an injury to the tailbone area, such as a fall.

  • Poor hygiene

Pilonidal cysts are more likely to develop with poor hygiene, especially around the buttocks.

How serious is a pilonidal cyst?

Pilonidal cysts are not typically life-threatening but can cause discomfort, pain, and other symptoms that interfere with daily activities. Leaving the cyst untreated or letting it become infected can result in serious health problems.

When a cyst becomes infected, it may develop an abscess or open sore that requires medical attention, including antibiotics and abscess drainage. Cellulitis, known as gangrene, is a more serious condition caused by the infection spreading to surrounding tissues.

Pilonidal sinuses can develop from cysts and tunnels under the skin that can become infected and cause discomfort and pain. In addition, the condition can recur even after treatment, particularly if the underlying cause, such as poor hygiene or prolonged sitting, isn’t addressed.

Even though pilonidal cysts may be uncomfortable and require treatment, they are generally not considered life-threatening or serious. Pilonidal cysts can become serious when they cause complications that don’t get prompt treatment. Pilonidal cysts may cause the following complications:


The cyst can become infected, resulting in an abscess, a painful, swollen area filled with pus. Medical attention, including antibiotics and drainage, may be required.


There are cases in which an abscess or cyst can cause cellulitis when the infection spreads to surrounding tissues. A cellulitis bacterial skin infection can cause redness, swelling, pain, and fever. In some cases, it can be a serious condition that requires medical attention.

Chronic pilonidal disease

Sometimes pilonidal cysts can develop into a chronic condition called chronic pilonidal disease. The development of multiple cysts or sinuses, ongoing drainage or infection, and ongoing discomfort characterize it.

Surgery complications

It may be necessary to remove the cyst surgically in some cases. As a result, there may be risks associated with this, such as bleeding, infection, or problems with wound healing.


Pilonidal cysts can recur after treatment, particularly when the underlying cause of the cyst isn’t resolved immediately, such as poor hygiene or prolonged sitting.

Spinal or neurological complications

If pilonidal cysts spread to the spinal cord or nerve roots, they can cause spinal or neurological complications. Leg or foot weakness, numbness, or tingling, as well as problems with bowel or bladder function, can be symptoms of a condition like this.


The formation of squamous cell carcinoma may result from pilonidal cysts. Squamous cell carcinoma is a rare form of skin cancer. The cyst may become inflamed or ulcerated if you notice bleeding, ulceration, or rapid growth in chronic or recurrent pilonidal disease.

Emotional distress

In the case of pilonidal cysts requiring surgery or causing persistent discomfort or drainage, they can be sources of significant emotional distress and embarrassment. A mental health professional or healthcare provider can provide support if needed since this can affect the quality of life and self-esteem.

Fistula formation

It is possible to form a fistula on a pilonidal cyst, an abnormal channel connecting the cyst to the skin or other tissues. Consequently, scarring, tissue damage, and discomfort may result from drainage and infection. In addition, fistulas can be difficult to treat and may require surgery or other interventions.


An infected pilonidal cyst can lead to sepsis, a life-threatening condition in which the body’s immune system responds to an infection by going into overdrive. As a result, symptoms such as fever, rapid heartbeat, confusion, and organ failure can occur. A patient with sepsis needs immediate medical attention and, if untreated, can die.

Even though pilonidal cysts are generally not considered life-threatening, they can cause discomfort and may need to be treated to avoid complications. Patients with symptoms of pilonidal cysts, such as tailbone pain or swelling, should seek medical attention.

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