Butt cyst (Pilonidal cyst): Why does it happen and how to cure it?

A bump on your tailbone is a symptom of a butt cyst or a pilonidal cyst. This can be painless, however, it can cause pain and fever if infected.

A butt cyst is also known as a pilonidal cyst. It is a small, usually round sac that forms near the tailbone at the top of the buttocks. The cyst can also contain hair, skin debris, and sometimes pus. The cyst may not cause any problems on its own. However, if it is infected, red or swollen, it can be a symptom of pus. It can also make it tough to sit or bend over.

Some people might be more prone to butt cysts due to their genetics, while others may have butt cysts due to ingrown hair. Friction from tight clothing or activities that involve a lot of sitting can contribute. An infected cyst can be drained, however, in extreme cases, it might require surgery as well.

What is a butt cyst?

A butt cyst is a round sac-like structure that is filled with fluid or air. It is situated at the crease of the buttocks, close to the tailbone. UK’s National Health Service states that while most butt cysts are harmless and not even noticeable, an infected cyst can turn out to be very painful. It can cause pain and swelling at the top of the cleft in your buttocks, and can also result in an abscess. Therefore, it is very important to get in checked on time. However, if the pilonidal cyst is not infected, then you can wait and watch as well, states the NHS.

Causes of butt cyst

A butt cyst can occur due to many reasons, the biggest one being ingrown hair. Here are some of the likely causes:

1. Ingrown hair

Loose hairs penetrate the skin in the natal cleft, that is the crease between the buttocks, due to friction. This might happen due to tight clothing, or even excessive sitting. The body perceives the embedded hair as a foreign object and triggers an inflammatory response. This inflammation leads to the formation of a cyst wall around the hair, trapping it along with dead skin cells and sometimes pus. A study, published in Clinics in Colon and Rectal Surgery, analyzed 40 pilonidal sinus specimens and found “hair fragments” in 97.5% of them.

Also Read

Butt cyst (Pilonidal cyst): Why does it happen and how to cure it?

2. Genetics

Your genetical predisposition can also cause butt cysts. A study, published in the International Journal of Trichology, states that a familial tendency can cause cysts in some cases.

3. Anatomy

The structure of your natal cleft can influence the likelihood of developing a cyst. A deeper cleft or specific tailbone structure might increase the risk of hair entrapment.

Who is more at risk of getting butt cysts?

Certain people are more at risk of getting pilonidal cysts. It is believed at men are two to three times more prone to getting butt cysts than women, states a study, published in Annals Medicine & Surgery. It also occurs between puberty and the age of 40 years, the average age is between 20 and 35 years.

A woman looking at her behind
Butt cysts can be painless. Image courtesy: Freepik

Symptoms of butt cysts

Some visible signs of pilonidal cysts can be observed. There will be a bump or swelling around your tailbone. The area will be tender, and you will notice pain while sitting or bending down. You might also experience other symptoms such as fever, redness and warmth. However, it is also important to note that not all butt cysts will be painful.

How to treat butt cysts?

Some butt cysts can be treated at home, but these are mild, painless cases. If you have a small, non-infected pilonidal cyst, your doctor might recommend home care initially to manage discomfort and potentially prevent further irritation.

  • Sitz baths with warm water can help soothe the area and promote drainage of any minor discharge. You can take these baths for 10-15 minutes, 2-3 times a day.
  • Maintaining good hygiene is crucial. Gently cleanse the area with warm water and mild soap during your regular showers or baths. Avoid harsh scrubbing or irritants.
  • Wearing loose-fitting clothing that reduces friction on the tailbone can help minimize discomfort.

However, infected or recurring cysts can require medical treatment.

  • For an infected cyst, a doctor might perform a procedure to drain the pus and debris. This can involve making a small incision and using packing to keep the area open for drainage and healing.
  • In some cases, depending on the severity of the infection, antibiotics might be prescribed to combat bacterial growth.

For recurrent cysts, there is an option of laser surgery, wide excision, and limberg flap surgery and many other known flap surgeries. There are different surgical techniques, and your doctor will discuss the most suitable one for your specific case. Some options include Sinusectomy, which involves removing the entire cyst wall and sinus tract to prevent recurrence. Limb flap surgery uses nearby healthy tissue to cover the surgical site and reduce the risk of recurrence.

However, early diagnosis and treatment is essential. Seeking medical attention at the first sign of a pilonidal cyst can help prevent complications, and help you heal faster.

A woman holding her upper thigh
A butt cyst should be shown to the doctor if it is swollen and red. Image courtesy: Freepik

How to prevent butt cysts?

Following good hygiene practices, maintaining a healthy weight, and wearing loose clothing can help reduce the risk of pilonidal cysts. Besides this, make sure to minimise ingrown hair, the keep the area clean and pat dry the area. However, there is no guarantee of preventing butt cysts.

Summary

A pilonidal cyst, also known as a butt cyst, is a small sac that forms near the tailbone. It typically contains hair, skin debris, and sometimes pus. While often harmless, it can become infected and cause pain, swelling, and difficulty sitting or bending.