Pilonidal Cyst Surgery: What to Expect

The good news is that pilonidal cyst surgery is both common and highly effective. “Thousands of people undergo this procedure each year,” affirms Dr. Stephen Chagares, a board-certified surgeon with Premier Surgical Network. “Surgery helps patients get long-term relief from the discomfort and recurring infections.”

Understanding Pilonidal Cyst Surgery

A pilonidal cyst is a small pocket that forms just beneath the skin near the tailbone. It is often filled with hair, skin debris, and fluid. While it may start as a minor bump, pilonidal cysts can become irritated and infected, leading to painful abscesses and drainage.

These cysts are most commonly caused by loose hairs that penetrate the skin and create a reaction beneath the surface. “Long hours of sitting, having coarse or thick body hair, and frequent friction in that area are some of the most common risk factors leading to pilonidal cyst infections that we’ve seen,” Dr. Chagares informs. 

In some cases, family history or repeated infections can predict patients who are more prone to developing pilonidal cysts.

For many patients, conservative measures—like antibiotics or drainage—offer only temporary relief. Because pilonidal cysts are highly likely to recur, surgical removal is often the best solution.

Identifying the Signs and Symptoms of Pilonidal Cysts

Pilonidal cysts can vary in severity, but there are some common signs to look out for. You may experience:

• Pain or tenderness near the tailbone, especially when sitting
• Swelling or a noticeable lump in the affected area
• Redness or warmth of the skin around the cyst
• Drainage of pus or blood, sometimes with an unpleasant odor
• Recurrent infections or abscesses in the same spot
• Fever or general discomfort when the cyst becomes severely infected

Like with many conditions, recognizing these symptoms early is essential, as prompt attention can prevent the condition from worsening. If you suspect you may have a pilonidal cyst, contact your healthcare provider.  They can confirm the diagnosis and recommend the most effective treatment plan, helping you avoid ongoing pain and recurrent infections.

Surgical Treatment Options for Pilonidal Cysts

“Depending on the condition, severity, and frequency of a patient’s cyst, we can recommend one of several surgical approaches,” says Dr. Chagares. 

Incision & Drainage (I&D)

I&D is a bridging procedure in which the surgeon makes a small cyst opening to drain infection and fluid when a cyst is acutely infected and causing significant pain. While it provides quick relief, it is a temporary measure, as the cyst is not technically removed and thus will likely require further treatment in the future after the infection has resolved.

Excision Surgery

This procedure involves removing the entire cyst and the surrounding tissue that may contribute to recurrence. Excision surgery is often recommended for patients who have experienced multiple infections or cysts that haven’t improved with more conservative treatments. It provides a more permanent solution by addressing the root cause of the cyst.

Excision with Flap Closure Surgery

For larger, more complex or recurring pilonidal cysts, excision with flap closure surgery may be recommended. In this advanced procedure, the surgeon removes the cyst and repositions nearby healthy tissue to close the area. This technique lowers the risk of recurrence in these cases and often promotes faster healing for this subset of pilonidal cyst patients. It is especially beneficial for patients with multiple cysts or who need a more durable, long-term solution.

Schedule Your Pilonidal Cyst Surgery Consultation Today

“Living with a pilonidal cyst can indeed be painful, frustrating, and disruptive—but with surgery, we can provide a highly effective path to long-term relief,” Dr. Chagares assures. While conservative treatments may provide temporary comfort, surgical options such as incision and drainage, excision or excision with flap closure are often the most reliable ways to prevent recurrence and restore quality of life.

If you suspect you may need surgery for a pilonidal cyst, it’s important not to delay seeking professional medical advice. By scheduling a consultation with Premier Surgical Network, you’ll receive a personalized treatment plan tailored to your condition and goals. Our team is dedicated to providing compassionate, expert care—helping you move forward with confidence, comfort, and peace of mind.