Treatments for Pilonidal Cysts: From Drainage to Surgery

Posted on August 15th, 2026

Illustrated diagram of a pilonidal cyst. A painful lump near your tailbone can make sitting, exercising, and completing everyday tasks uncomfortable. When a pilonidal cyst becomes infected, it may also cause swelling, redness, or drainage. At Piedmont Colorectal Associates in Atlanta, GA, board-certified colorectal surgeons evaluate pilonidal disease and recommend treatment based on the severity of the infection, whether the condition has returned, and the presence of underlying sinus tracts.

What Is a Pilonidal Cyst?

A pilonidal cyst is a pocket beneath the skin that commonly develops near the top of the crease between the buttocks. It may contain hair, skin debris, or fluid. Some cysts remain small and cause few symptoms, while others become infected and develop into painful abscesses. Pilonidal disease may also create one or more sinus tracts beneath the skin. These small channels can cause recurring swelling or drainage, even after an acute infection has improved.

When Is Drainage the Right Treatment?

An infected pilonidal cyst often requires incision and drainage. After numbing the area, the surgeon makes a small opening that allows pus and infected material to drain. This can relieve pressure and reduce the pain caused by an abscess. Drainage treats the immediate infection, but it may not remove the cyst, trapped hair, or sinus tracts responsible for the problem. For that reason, some patients experience another infection in the same area. Antibiotics may occasionally be prescribed when a surrounding skin infection is present or other clinical factors are present, but they do not typically replace abscess drainage.

When May Surgery Be Recommended?

Surgery may be considered when pilonidal cysts repeatedly become infected, continue draining, or develop multiple sinus openings. The goal is to remove or address the diseased tissue and reduce the likelihood of future episodes. Several surgical approaches are available. Depending on the extent of the condition, the wound may be left open to heal gradually or closed after the affected tissue is removed. Some procedures reposition the incision away from the deepest part of the buttock crease, where moisture, pressure, and friction can interfere with healing. The appropriate technique depends on the disease pattern, previous treatments, and your individual anatomy.

How Can You Support Healing and Reduce Recurrence?

Careful wound care is an important part of recovery after drainage or surgery. Your surgeon may recommend keeping the area clean and dry, temporarily limiting certain activities, and managing hair around the treatment site. Following these instructions can support healing and help lower the risk of another infection.

Find the Right Treatment for Pilonidal Disease

A pilonidal cyst that repeatedly swells, drains, or becomes painful deserves a specialist’s attention. The experienced team at Piedmont Colorectal Associates provides discreet evaluations and individualized treatment options for patients throughout Atlanta. Contact our practice at (404) 351-7900 to schedule an appointment and discuss whether drainage or surgery is appropriate for you.
This entry was posted in Pilonidal Cysts and tagged atlanta, . Bookmark the permalink.