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Pilondial Cysts

Pilondial Cyst – Cyst Removal – Northern Virginia

Pilondial cysts are painful or uncomfortable pimple-like growths that form when a hair gets into the skin and becomes embedded causing inflammation.

Pilondial Cysts Overview


If you’re someone whose job or lifestyle includes long periods of sitting, you may find yourself dealing with the pain and discomfort of pilonidal cysts.

These pimple-like elements occur when a hair works its way into the skin and becomes embedded. The result can become an inflamed area under and around the surface that has the potential to cause pain and to become infected. They are created as a result of friction and pressure created by skin against skin. Commonly, these abnormal pockets of skin are located near the tailbone, directly above the cleft in the buttocks. Ashburn, VA cosmetic surgeon, Dr. Timothy Mountcastle, uses a variety of methods to treat and remove these bothersome cysts.

Pilonidal Cyst removal before VA Pilonidal Cyst removal after VA

Pilondial Cysts Before and After

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Surgical Technique


Temporary help for the pain caused by pilonidal cysts can be as quick as a warm soak in the tub. For cysts that are painful, swollen, or leaking pus or blood, it’s important to see a medical practitioner for help. When you meet with the doctor, they will ask how long you have dealt with the cyst, what makes the discomfort better or worse, and if you are currently taking any medicines or supplements. Infected pilonidal cysts need to be drained before healing can begin. If pilonidal cysts are left untreated, there is a potential for a slightly increased risk of squamous cell carcinoma, a form of skin cancer.

Less severe cysts can be drained through a small incision conducted during an in-office medical procedure. Larger cysts that have a tendency to reoccur will often need to be removed surgically. Depending on the medical practitioner, this, too, can be an in-office procedure. Prior to beginning the drainage or removal process, the area will be numbed with a small injection.

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During/After Surgery

In the Cleft Lift or Modified Karydakis option, the incisions avoid the midline of the buttocks. The wound is closed with sutures and only requires a minimum amount of tissue removal. There is no portal for the entry of hair. After surgery, the wound is packed with dressing and left open to heal from the inside out. This is generally a slower healing time, but it has been found to be more effective for long-term healing. Post-surgery, the wound is closed with tiny stitches. Because the area is immediately closed up, the healing process can be more complicated as a result. Follow-up wound care is particularly important, and shaving in the area is another way to prevent reoccurrences.

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Pilondial Cysts Faqs

What causes Pilondial Cysts?

Most medical practitioners believe that pilonidal cysts are caused by the embedment of coarse hair under the surface of the skin. Others hypothesize that the cysts could be caused by stretching the deep layers of skin that trigger the enlargement and eventual rupture of a hair follicle. Once the eruption occurs, then the cyst grows around the rupture. When the pilonidal cyst was first observed in officers during World War II, it was attributed to the impact caused by bumping around in a Jeep. Thus, the cysts were called “Jeep Disease.” They are also found more commonly in men than in women. Other potential causes of this painful situation can include wearing tight clothing, bicycling, and sitting in the same position for extended periods of time.


What are the risk factors?

  • Long-periods of sitting
  • Obesity
  • Inactivity
  • Excessive amounts of body hair
  • Poor hygiene
  • Stiff or coarse body hair

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