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Causes
By Mayo Clinic staffThere is some disagreement about what causes pilonidal cysts. Most pilonidal cysts appear to be caused by loose hairs that penetrate the skin. Friction and pressure — skin rubbing against skin, tight clothing, bicycling, long periods of sitting or similar factors — force the hair down into skin. Responding to the hair as a foreign substance, the body creates a cyst around the hair.
This explanation accounts for rare cases of pilonidal cysts that occur in parts of the body other than near the tailbone. For example, barbers, dog groomers and sheep shearers have developed pilonidal cysts in the skin between fingers.
Another possible explanation is that normal stretching or motion of deep layers of skin causes the enlargement and rupture of a hair follicle, the structure from which a hair grows. A cyst then forms around the ruptured follicle.
Some children are born with a small indentation in the skin (sacral dimple) near the top of the cleft of the buttocks. Rarely, a sacral dimple may become infected, essentially forming a pilonidal abscess.
- Humphries AE, et al. Evaluation and management of pilonidal disease. The Surgical Clinics of North America. 2010;90:113.
- Sullivan DJ, et al. Pilonidal disease. http://www.uptodate.com/home/index.html. Accessed March 18, 2010.
- AL-Khamis A, et al. Healing by primary versus secondary intention after surgical treatment for pilonidal sinus. Cochrane Database of Systematic Reviews. 2010:CD006213.
- Pilonidal disease. American Society of Colon and Rectal Surgeons. http://www.fascrs.org/patients/conditions/pilonidal_disease/. Accessed March 16, 2010.
- Bullard Dunn KM, et al. Colon, rectum and anus. In: Brunicardi FC, et al. Schwartz's Principles of Surgery. 9th ed. New York, N.Y.: The McGraw-Hill Companies; 2010. http://www.accessmedicine.com/content.aspx?aID=5015668&searchStr=pilonidal+cyst#5015668. Accessed March 17, 2010.
- Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. March 22, 2010.
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