Pilonidal cyst illustration

Pilonidal disease is a chronic condition that affects the skin and tissue of the crease between the buttocks.  This condition is believed to occur when hair follicles in this area become clogged, leading to infection and pain. The body's immune system treats the hair follicle as a foreign object and forms a fluid-filled cyst around the area - often called a pilonidal cyst or pilonidal sinus. Pilonidal disease usually affects boys more than girls and are more common in adolescents and young adults (ages 13-21) when body hair grows and oil production increase. 

Some other causes of this condition include: 

  • A lot of body hair – specifically coarse or curly hair
  • Family history of pilonidal cysts
  • Sitting for long periods of time
  • Being overweight
  • Having a deep gluteal cleft in the buttock


The first symptom is usually pain when sitting down. Other symptoms include a tender lump or cyst, redness, swelling, pus or fluid draining from the cyst, and fever.  

Possible Treatments

Antibiotics are usually recommended to help treat the infection. The treatment of pilonidal disease starts with hair removal and hygiene. The Arkansas Children's surgical team offers laser hair removal for those with dark, coarse hair. "Pit" or "sinus" removal can also be provided after addressing infections. This technique is less invasive than traditional surgery and is tolerated well by patients. 

Cysts can recur (or come back) if the hair isn't removed. Removing the hair relieves the pain and the infection.  

The team of experts at Arkansas Children's understand and work with our teenage patients to develop a treatment plan. Our minimally invasive approach lets patients get back to normal activities as soon as possible with few restrictions. 

Meet the Team