What are the other Names for this Condition? (Also known as/Synonyms)

• Pilonidal Cyst Abscess
• Pilonidal Sinus Abscess

What is Pilonidal Abscess? (Definition/Background Information)

• A pilonidal cyst forms in the lower spinal region, near the tailbone, due to obstruction of the pilonidal sinus tract with keratinous material. When pilonidal sinus or cyst is infected, it results in the formation of a Pilonidal Abscess
• This condition is generally seen in young adults. Typically, a bacterial infection of the pilonidal cyst causes the formation of an abscess (a pus-filled sac)
• A Pilonidal Abscess may be treated using antibiotics and thorough surgical ablation of the fluid-filled cyst. This may be followed by packing the resultant defect using second intention healing. This leads to a higher cure rate than suturing the defect closed
• The prognosis of Pilonidal Abscess depends upon several factors including on the severity of the signs and symptoms. However, generally the prognosis is excellent with suitable treatment

Who gets Pilonidal Abscess? (Age and Sex Distribution)

• Pilonidal Abscess is rare and can occur at any age; usually young adults are affected the most
• Both males and females are affected, but a male predominance is seen
• Individuals of all racial and ethnic background may be affected

What are the Risk Factors for Pilonidal Abscess? (Predisposing Factors)

The primary risk factor for Pilonidal Abscess formation is the presence of a pilonidal cyst. The cyst may develop due to the following risk factors:

• Obesity
• Excessive body hair, or the presence of coarse hair on the body
• Prolonged sitting by nature of one’s occupation
• Lifestyle lacking physical activities and exercises
• Positive family history of the condition
• Trauma to the tailbone region
• Lack of proper personal hygiene
• It can form a part of follicular occlusion syndrome along-with other skin conditions that include hidradenitis suppurativa, acne conglobata, and dissecting cellulitis of scalp

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Pilonidal Abscess? (Etiology)

A Pilonidal Abscess develops when the pilonidal sinus tract or cyst is infected. The infection results in the formation of a pus-filled abscess.

What are the Signs and Symptoms of Pilonidal Abscess?

The signs and symptoms of Pilonidal Abscess may include:

• Infection of the pilonidal cyst resulting in a pus-filled and painful lesion located deep in the skin at the upper region of the buttock cleft (at the base of the spine)
• The infection may cause associated signs and symptoms such as fever and inflammation
• The cyst can break and release foul-smelling pus and fluids
• When this ruptured cyst heals, it can cause scarring of the skin

Some cases are mild, while others may be severe.

How is Pilonidal Abscess Diagnosed?

A diagnosis of Pilonidal Abscess may involve the following:

• A thorough medical history and physical examination: In many cases, Pilonidal Abscess is diagnosed based on the presenting symptoms and no further lab tests may be necessary
• Blood tests
• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Culture studies of the fluid being drained
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Pilonidal Abscess?

Pilonidal Abscess may result in the following complications:

• Chronic conditions can cause prolonged sitting difficulty
• Longstanding or recurrent abscess is known to turn into squamous cell carcinoma (infrequently)
• Pilonidal Abscesses may require treatment through surgical intervention

How is Pilonidal Abscess Treated?

The treatment of Pilonidal Abscess is based upon the severity of the condition and may involve the following:

• Surgical removal of the pilonidal cyst and drainage of the abscess
• Medications, such as antibiotics, may be used for bacterial infection
• Topical applications following the surgical abscess drainage procedure for faster surgical wound healing

How can Pilonidal Abscess be Prevented?

Early detection and prompt treatment of a pilonidal cyst may help in preventing the formation of a Pilonidal Abscess.

What is the Prognosis of Pilonidal Abscess? (Outcomes/Resolutions)

• The prognosis of Pilonidal Abscess depends upon the severity of the signs and symptoms and the response to treatment
• In most cases, the prognosis of the condition is good with adequate surgical treatment (drainage of the pus)

Additional and Relevant Useful Information for Pilonidal Abscess:

• There is no evidence to prove that oily foods and chocolate-based products have an influence on Pilonidal Abscess formation
• Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition
• The presence of dirt on the body is not a causative factor for the condition. However, it helps to be clean and hygienic, which may help the condition from getting worse