Can Pilonidal Cysts Come Back?

Pilonidal disease is when a cyst or abscess forms in the tailbone area. Even with treatment pilonidal cysts can return. In this article, we will explore the causes, symptoms, and treatment options for recurrent pilonidal disease. The recurrence rate for pilonidal abscesses is around 20%.

Why does my pilonidal cyst keep coming back?

We do not fully understand the exact cause of recurrent pilonidal disease. However, several factors may contribute to its development. These include:

  • Residual Tissue: Sometimes, after treating a pilonidal cyst, there may still be small pockets of leftover tissue. These pockets can become infected and lead to the recurrence of the cyst.
  • Hair Follicle Issues: Hair follicles play a role in the formation of pilonidal cysts. Issues in the hair follicles, such as ingrown hairs or excessive hair growth, can increase the risk of recurrence.
  • Poor Wound Healing: Improper wound healing after the initial treatment can also contribute to a pilonidal cyst coming back. Infection, inadequate wound closure, or poor wound care can hinder the healing process and lead to the formation of a new cyst.

Symptoms of Recurrent Pilonidal Disease

The symptoms of recurrent pilonidal disease are similar to those of an initial pilonidal cyst. These may include:

  • Pain and Discomfort: Recurrent cysts can cause pain and discomfort in the tailbone region. The pain may worsen with prolonged sitting or physical activity.
  • Swelling and Redness: The affected area may become swollen, red, and tender to the touch.
  • Drainage of Pus or Blood: Recurrent cysts may produce a discharge of pus or blood. A foul odor can accompany this.

Treatment Options for Recurrent Pilonidal Disease

The treatment of recurrent pilonidal disease depends on the severity of the condition. Here are some common treatment options:

  • Incision and Drainage: If the cyst is small and not causing many problems, a doctor may perform a small procedure. This procedure aims to remove fluid from the cyst and alleviate the symptoms.
  • Excision and Closure: In cases of recurrent or severe pilonidal disease, surgical excision of the cyst and surrounding tissue may be necessary
  • Cutting-Edge Flap-Based Pilonidal Technique: Dr. Nasseri and Dr. Barnajian, here at the Pilonidal Institute have developed an advanced outpatient technique to alleviate symptoms and reduce the chances of cysts returning. This method, known as bilateral fasciocutaneous gluteal flaps with tie over sutures and extracellular matrix, has been refined over decades.

How to Prevent a Pilonidal Cyst Recurrence?

Preventing the recurrence of pilonidal cysts is crucial for long-term well-being. Although some factors may be beyond your control, taking proactive measures can significantly decrease the risk of cysts recurring. Here are key strategies to minimize the chances of recurrence:

  • Maintain Good Hygiene: Keep the affected area clean and dry. Additionally, practice regular cleansing to prevent bacterial buildup.
  • Hair Removal Techniques: Consider removing body hair in the affected area to reduce the risk of ingrown hairs. Shaving or hair removal creams can help maintain a hair-free environment.
  • Avoid Prolonged Sitting: Limit prolonged periods of sitting, especially on hard surfaces.
    If sitting for extended periods is unavoidable, use a cushion or take periodic breaks.
  • Choose Loose-Fitting Clothing: Wear loose-fitting clothing to reduce friction and irritation in the tailbone area. Avoid tight belts or pants that may contribute to pressure on the affected area.
  • Weight Management: Maintain a healthy weight to reduce stress on the coccyx and surrounding tissues. Adopting a balanced diet and regular exercise can assist with weight management and support overall well-being.

If you suspect you have a recurring pilonidal cyst or are experiencing symptoms, consult a Pilonidal Cyst Specialist for an accurate diagnosis and appropriate treatment. Timely intervention can alleviate discomfort and promote faster recovery.

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