What do Pilonidal Cysts Look Like?

Pilonidal cysts are an often painful condition that form at the base of the tailbone near the top of the buttocks cleft causing significant discomfort and impact daily life. These cysts result from an infection of the hair follicles, which causes a painful abscess. Factors like prolonged sitting, friction, and poor hygiene can exacerbate the condition, leading to the formation of a cyst.

Understanding what these cysts look like and recognizing their symptoms can help in seeking timely treatment and avoiding complications.

How do Pilonidal Cysts Look Like in the Early Stages?

In the initial stages, a pilonidal cyst may appear as a small, swollen, and tender lump. This lump is often red and feels warm to the touch. It might be mistaken for a simple pimple or boil. However, unlike regular pimples, pilonidal cysts do not resolve on their own and can worsen if left untreated. According to studies, pilonidal disease is most prevalent in young adults, particularly males, with an incidence rate of approximately 26 per 100,000 individuals per year.

Visual Indicators of Early Stage Pilonidal Disease

  • Redness and Swelling: The skin around the cyst will typically be red and inflamed.
  • Pain: There is usually significant pain and tenderness in the affected area, especially when sitting or applying pressure.
  • Drainage: The cyst may drain pus or blood, which can cause foul-smelling discharge.

Advanced Stages and Complications of Pilonidal Cysts

As the condition progresses, the cyst may form a sinus tract, an abnormal channel that can lead to multiple openings on the skin’s surface. This stage often requires more extensive treatment, including surgical intervention.

Visual Indicators of Advanced Pilonidal Disease

  • Multiple Openings: There may be several small holes above the anus that bleed or drain pus. These are known as sinus tracts and can complicate the infection.
  • Chronic Inflammation: The area remains consistently red, swollen, and painful.
  • Scar Tissue: Repeated infections can lead to the formation of scar tissue, making the area harder and more difficult to treat.

What Conditions Mimic Pilonidal Cysts?

Several other conditions can present with similar symptoms, making it crucial to differentiate them for proper treatment:

  • Perianal Abscess: This is a collection of pus near the anus, similar in appearance but often more localized.
  • Anal Sinus: A benign condition involving a small opening near the anus that can sometimes drain, resembling a pilonidal sinus.
  • Folliculitis: Inflammation of hair follicles that can occur anywhere on the body, including the buttocks, but is typically more superficial.
  • Hidradenitis Suppurativa: A chronic skin condition causing abscesses and scarring, often found in areas where skin rubs together.


Understanding what pilonidal cysts look like and how they develop is crucial for seeking timely and effective treatment. Early intervention can prevent complications and improve recovery outcomes.

If you notice symptoms similar to those described or see visual indicators in pilonidal cyst photos or pictures of pilonidal sinus, give us a call at 310-807-6952 to schedule a consultation with one of our pilonidal specialists. 

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