Pilonidal Cyst Operation (Hair Cyst)

Pilonidal Cyst Operation (Hair Cyst)

Pilonidal Cyst appears in young adults in particular, and it often tends to relapse, so its treatment requires highly qualified and experienced hands to perform the pilonidal process surgery, which is what Turkish doctors provide.

What is a Pilonidal Sinus (hair cyst)?

It is called a Pilonidal Fistula (anal fistula) or a Pilonidal Cyst, and it is a cyst located in the skin containing hair and skin residues that appears at the base of the coccyx bone at the top of the fissure between the buttocks (anal).

Doctors believed that coccygeal fistula was a congenital condition, but with time it was discovered that it arises as a result of the reversal of some hair around the soft tissue and its penetration into the skin, where the body deals with this hair as a foreign body, which leads to the formation of a hair bag (pilonidal sinus). And the occurrence of the observed thickening of the skin.

A picture showing the pilonidal cyst and its components and in which layer of the skin it most often arises
An image showing the pilonidal cyst and its components and in which layer of the skin it often arises, and it helps doctors in Turkey to choose the appropriate treatment method

Pilonidal fistula usually affects men 2.2 times more often than women and it often appears before the age of 40 (20-30).

A pilonidal Cyst can become infected, become very painful, and may become so severe that it does not respond to antibiotics or other initial treatments.
High-risk patients are those who sit for long periods of time without moving, such as truck drivers, office workers, cyclists...

Some patients can develop a coccygeal fistula in different places such as the fingers of the hands of barbers and sheep and cow breeders.

Symptoms of a Pilonidal Cyst

If the fistula does not become infected, there are usually no symptoms, or there may be slight discomfort when sitting on the same site as the fistula, or in the event of inflammation of the fistula. In the case of infection, what is known as a pilonidal abscess is formed. The abscess of the Pilonidal Sinus manifests itself with the following symptoms:

  • Redness of the skin
  • Pain
  • Pus leaking from the fistula
  • Bad smell due to pus
  • Fever

Treatment of the pilonidal cyst must be prompt, otherwise the condition will worsen or even develop (even in a small percentage) into a squamous cell carcinoma (SCC).

Preparations before the operation of Pilonidal Cyst

Patients will undergo a physical examination by the surgeon to discuss symptoms and determine the appropriate surgical treatment method. Preparations vary according to the type of pilonidal cyst operation performed. Routine blood tests are usually not needed but may be requested before surgery based on the age of the patient and the presence of any medical problems he has, and it may be requested for some patients to stop taking certain medications before surgery.
The doctor usually asks the patient to stop eating 8 hours before the operation

What are the types of pilonidal surgery common in Turkey?

There are two common operations for the treatment of pilonidal sinus (hair cyst) in Turkey, but other surgical methods are being studied, whether or not, where they study the extent of their effectiveness in treating without complications and preventing recurrence of the pilonidal sinus. Recently, the cure rate of pilonidal sinus has increased in Turkey due to the development of Surgical methods have the competence of doctors.

The process of incision and drainage of the Pilonidal Cyst

It is a small operation that is carried out in the doctor's clinic under local anesthesia only (local anesthesia is sufficient here), and is recommended for patients who has a pilonidal cyst for the first time and the infection is often mild.

The doctor makes an incision in the pilonidal cyst, through which the fluid and pus in the fistula are drained, and then puts cotton and gauze in the wound and leaves it open until the cyst shrinks and goes away ,the tampon (whether it was from cotton or gauze) must be changed constantly, and this is called the open wound method, which has better results in terms of preventing relapse of the pilonidal fistula.

The doctor can close the wound and sew it up, and this method is the closed wound method, but the recurrence in this method is high.

After this operation, it is recommended that the patient remove hair either by shaving or by laser around the cyst area (lower back) to reduce the rate of recurrence.

Pilonidal Cyst Excision

In the event that the patient has problems with the incision and drainage of the pilonidal sinus at an earlier time, or the infection is very bad, or the patient has several pilonidal fistulas accompanied by capillary sinuses, then the pilonidal cyst operation becomes a necessity, as we need a more effective treatment and a larger surgery, which is Pilonidal fistula excision.

Pilonidal cyst surgery is an out-of-clinic operation that takes place in the hospital in the operating room, where the operation of the pilonidal cyst is performed by a specialized surgeon, and the patient often stays for one night in the hospital, where the patient is given general anesthesia or regional anesthesia for the lower part of the body (general anesthesia is better), After that, the surgeon makes a surgical incision and removes a specific amount of tissue (depending on the depth of the cyst and the number of fistulas) around the fistula and then removes the fistula itself. As in the previous operation, we can resort to the open or closed surgical method.

A picture showing the types of operation to remove a pilonidal cyst
B: Operation of incision and drainage of the pilonidal cyst C: Operation of excision of the pilonidal cyst

The wound must be carefully taken care of until it heals, otherwise the infection will return after a few days and the fistula will relapse, as the doctor or nurse's instructions must be followed completely to prevent what we mentioned from happening.

Other Methods

Other methods that are less invasive than the previous methods of treating pilonidal cyst are currently being studied and studies The efficacy of these methods in the treatment of pilonidal fistula (hair cyst) as (Video-assisted pilonidal sinus resection or Laparoscopic Pilonidal Sinus Excision).


The process of pilonidal fistula with the methods mentioned is a safe process, as we hardly see complications of the fistula process except perhaps pain, and this is normal and varies for different cases, as any surgery cannot go without any kind of complications.

Other complications can arise as a result of re-infection in the fistula and lack of good care of the wound, and the symptoms of re-infection in the fistula are the same as mentioned earlier in the article.

A pilonidal cyst operation has a high percentage of relapse if not managed properly, and several operations may be needed to get rid of a pilonidal cyst completely.

Pilonidal sinus treatment at home

Home treatment is a relative matter, so what works for one patient may lead to serious complications in another patient, so Bimaristan center recommends not to take recipes from the Internet randomly and without Medical consultation.

Pilonidal sinus can be treated at home through several traditional, non-surgical methods, but this treatment remains palliative and may not be completely curable or does not lead to the complete disappearance of symptoms, and some recipes can increase symptoms rather than relieve them, and that The success of a treatment method for one person does not necessarily mean the success of this method for another patient or for all patients.

Among these home remedies we mention:

  • Hot compresses: Using hot compresses several times a day can help soothe inflammation, as the heat emanating from the compress allows the drainage of pus from the pilonidal cyst (pilonidal sinus) and thus relieves pain.
  • Aloe Vera: This oil contains anti-inflammatory and anti-bacterial properties that can help relieve symptoms.
  • Globally approved anti-inflammatory creams.
  • Shaving the pilonidal sinus area.
  • Clean the fistula area regularly.

Recovery after pilonidal surgery

The recovery time from the operation varies according to the type and method of the operation (ie, whether the wound is left open or closed) and often the healing process is about a month or two (the healing period is longer in the case of an open wound).

The doctor may prescribe pain-relieving medications or some special wound baths, and he may prescribe some antibiotics to ensure that the infection is cured and does not recur.

Most patients can return to work the day after the operation, but some activities must be avoided until the condition fully recovers, and some instructions and doctor's advice must be followed to ensure that there is no recurrence, as the doctor may recommend:

  • Avoid doing strenuous work.
  • Avoid sitting for long periods.
  • Avoid riding a bike.
  • Weight loss in obese patients.
  • Shaving the area constantly, either by shaving or using a laser, and cleaning the area constantly, especially the wound opening.


  1.  ClevelandClinic
  2. MedlinePlus
  3. Healthline
  4. HealthyHorns

Frequently Asked Questions

If the case is simple, some cleaning methods (sitz baths) or antibiotics can suffice, but most often patients do not see the doctor until symptoms appear and the fistula develops.

The condition worsens and the cyst gets infected and blood, pus and other secretions come out of it, causing severe pain, and there is even a possibility of the condition developing into squamous cell carcinoma.

It is advised to avoid sitting for long periods of time unless necessary, otherwise you should choose a comfortable chair and shave the area under the coccyx constantly.

The incision and drainage of the fistula is a simple in-clinic operation.

As for the operation to remove the pilonidal cyst, it is usually performed in the operating room under general anesthesia, but due to the development of surgical methods and medical equipment, the process of pilonidal cyst in Turkey has become a simple operation with hardly any difficulty.

In the case of a closed wound, the secretions can last up to three or four weeks, while in the case of an open wound, it can last for several months.

Exudation and moderate drainage from a closed wound is normal.

If the pilonidal sinus is left untreated, the condition worsens and the cyst gets infected and blood, pus and other secretions come out of it and cause severe pain, and there is even a possibility of the condition developing into squamous cell carcinoma.

Most patients can sit after a week to two, but the problem lies in sitting for long periods, so you should avoid sitting for more than two hours continuously, and if necessary, you can use a comfortable rounded sofa with a hollow center.

The healing time of an open fistula can take about four months to half a year, and it depends on the extent to which the patient changes his daily habits, takes care of his health and follows the doctor's recommendations.

If you are planning for treatment in Turkey
you can talk to us here.

If you are planning for treatment in Turkey
you can talk to us here.