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Surgery for pilonidal cyst

Pilonidal abscess; Pilonidal dimple; Pilonidal disease; Pilonidal cyst; Pilonidal sinus

A pilonidal cyst is a pocket that forms around a hair follicle in the crease between the buttocks. The area may look like a small pit or pore in the skin that contains a dark spot or hair. Sometimes the cyst can become infected, and this is called a pilonidal abscess.

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An infected pilonidal cyst or abscess requires surgical drainage. It will not heal with antibiotic medicines alone. If you continue to have infections, the pilonidal cyst can be removed by surgery.

There are several types of surgery.

Incision and drainage -- This is the most common treatment for an infected cyst. It is a simple procedure done in your health care provider's office.

Pilonidal cystectomy -- If you keep having problems with a pilonidal cyst, it can be removed surgically. This procedure is done as an outpatient procedure, so you will not need to spend the night in the hospital.

It may be hard to remove the entire cyst, so there is a chance that it will come back.

Why the Procedure Is Performed

Surgery is needed to drain and remove a pilonidal cyst that does not heal.

Non-surgical treatment may be used if the area is not infected:


Pilonidal cyst resection is generally safe. Ask your provider about these complications:

Before the Procedure

Meet with your provider to make sure medical problems, such as diabetes, high blood pressure, and heart or lung problems are in good control.

Tell your surgeon:

On the day of the surgery:

After the Procedure

After the procedure:

Outlook (Prognosis)

Pilonidal cysts come back in about one half of the people who have surgery the first time. Even after a second surgery, it may come back.


Hyman N, Umanskiy K. Anus. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 53.

Johnson EK, Vogel JD, Cowan ML, et al. The American Society of Colon and Rectal Surgeons' clinical practice guidelines for the management of pilonidal disease. Dis Colon Rectum. 2019;62(2):146-157. PMID: 30640830

Wells K, Pendola M. Pilonidal disease and perianal hidradenitis. In: Yeo CJ, ed. Shackelford's Surgery of the Alimentary Tract. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 153.


Review Date: 9/9/2023  

Reviewed By: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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