Pilonidal cyst is a cyst that develops at the bottom of the back, near the coccyx or tailbone. It can cause severe pain when infected and filled with pus. Once it is infected, it is called “pilonidal abscess,”. It looks like a big pimple or pustule at the bottom of the tailbone. It is more commonly seen in men than in women and more often in younger people. During World War II, a large number of soldiers got this disease that needed hospitalisation. It is thought to be developed from the irritation from riding sitting in the bumpy jeeps for long. So, in those times, the condition was called “Jeep disease.”
Those who sit for a long time, like truck drivers, are more prone to this disease. They can be treated successfully in most cases. If it is inflamed & painful, it can be drained or taken out surgically.
Signs & symptoms
Pain, redness, tenderness and swelling at the bottom of the spine
Pus or blood draining out of it with bad smell
The cause of pilonidal cyst is not exactly known. But most of them are caused by loose hairs that penetrate the skin. Friction and pressure, caused by skin rubbing against skin, tight clothing, bicycling, long periods of sitting or similar factors force the hair go or grow down into the skin.
Pilonidal means “nest of hair,” and hair follicles are found inside the cyst while removing it surgically. Experts say ingrown hairs are the most common cause of pilonidal cyst.
Another theory suggests that pilonidal cysts appear after a trauma to that are in the body.
A small dimple in the skin between buttocks at birth can be a risk factor for developing pilonidal cyst later in life.
Other risk factors include obesity, long & thick hair, sedentary lifestyle, prolonged sitting, and excessive sweating.
Hypothesises say that hair penetrates into the subcutaneous tissues through dilated hair follicles. It happens particularly in late adolescence, though follicles are not found in the walls of cysts. Upon sitting or bending, hair follicles can break and open a pit. Debris is collected in that pit, then a sinus develops with a short tract, with a suction-like mechanism, leading to further penetration of the hair into the subcutaneous tissue.This sinus tends to extend again, mostly due to mechanical forces involved in sitting or bending. A foreign body reaction can happen to formation of an abscess. Infection may end up in abscess formation.
Microscopically, the sinus where the hair enters is lined with stratified squamous epithelium with slight cornification. Additional sinuses are frequent. Cyst cavities are lined with chronic granulation tissue and may contain hair, epithelial debris, and young granulation tissue. Cutaneous appendages are not seen in the wall of cysts, meaning the cysts lack epithelial lining, unlike the sinus. Cellular infiltration consists of lymphocytes, and plasma cells in varying proportions. Foreign body giant cells in association with dead hairs are a frequent finding.
In most of the cases, physical examination with detailed history can confirm the diagnosis
In rare cases, imaging techniques like USG, MRI etc. will be required.
Antibiotics do not heal a pilonidal cyst. But there are therapeutic procedures including:
Incision and drainage: It is done mostly in a first pilonidal cyst. Making a cut into the cyst and draining it. Then any hair follicles are removed and leaves the wound open, packing the space with gauze.
Marsupialization: In this procedure, A cut is made and pus is drained. After removing pus and any hair that are inside, the doctor will sew the edges of the cut to the wound edges to make a pouch.
Incision, drainage and closing of wound: The cyst is drained, but it’s not left open. The wound is closed surgically.
It is important to obey all instructions by doctor, after a surgery.
Try to keep the area clean. Check for any signs of a new infection, such as redness, pus, or pain.
Continue regular follow ups to ensure the healing of the cyst.
A complete cure is possible in most of surgically removed pilonidal cysts, but chance of recurrence is high.
Recurrence of the pilonidal cyst.
Systemic infection (infection that spreads throughout the body)
Rarely, squamous cell carcinoma, a form of skin cancer
Disease & Ayurveda
Asaadhuvrtha – inadequate drainage of sopha(swelling) or pooya(pus)
When the foreign body causes inflammation & swelling a cyst like sopha forms. In cases where this sopha is not incised& drained properly, the inflammation spreads into deeper tissues in the form of a tunnel and develops the naadeevrana.
One open wound on the skin outside the body
Pain & swelling, pain will be continuous & severe
Reddish,blackish discolouration may be present
Continuous and sero-sanguineous pus discharge from the open side
Fever and other systemic signs of inflammation will be present in acute infections.
Sallyaja/aaganthu (due to the presence of a foreign body)
When nadeevrana is formed due to a foreign body, it should be extracted surgically. Once the foreign body is completely removed and the pus is drained out completely, the treatment for wound healing should be done. Symptomatic management for pain relief should be done along with main treatment.
Upanaaha – bandage to prepare the area for extraction of sallya inside
Poorana – filling up the naadee with herbs
Bandhana – bandage of the clear wound after the surgery
Kshaalana – washing the area with wound healing medicines
Paatanam/Chedanam/Vidaaranam – surgical removal of foreign body
Sallyanirharanam – extraction of sallya
Margapravisodhanam – drainage pus and residual tissue
Then treatment of wound should be done
Commonly used medicines
Sit bath or soak the area in a tub of warm water
Keep the cyst and area around it clean and dry
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, honey
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Protect yourself from hot climate.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle. Be active.
Avoid continuous sitting and squatting.
Exercises are completely restricted in cases of a severe infection. In mild cases or after surgery & follow up, regular stretching and mild cardio exercises are advised. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
*These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake. Ayurveda Supplement with GMP Certification from India.
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.
Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.
Dr. Nair is a regular speaker at Ayurveda-related conferences and has visited Germany to propagate Ayurveda. You can write directly to him-
Whatsapp – +91 9446918019, +91 8075810816
To give you a quick idea about Ayurvedaforall, we are a group of ayurvedic practitioners committed to propagating Ayurveda in its best tradition around the world. Our online store sells authentic ayurvedic formulations backed by professional advice. Now into the seventeenth year of operation, the site has helped us build a dedicated clientele that regularly uses our products and services as well as refers others to us. Needless to say, this has been achieved through our adherence to the highest standards of customer service and professional ethics.