There are different treatments for an inflamed or infected pilonidal cyst. Treatment depends on whether the cyst drains on its own or not. The doctor will talk with you about which treatment is best for you.

Treatments can include:

  • Antibiotics. In some cases, antibiotics may be the best first choice. The infection may get better without the need for lancing (draining) or surgery.
  • Lancing (draining) the cyst. This is more common if the cyst is tender, has gotten larger and has softened where there may be pus under the skin. The doctor will numb your skin and make a small hole to let the cyst drain. The doctor may wash out the wound and pack it with gauze, leaving a small piece of gauze outside. This helps the cyst heal.
  • Surgery to remove the cyst may be needed if swelling and infections keep coming back. The doctor will talk with you about the different surgeries, depending on your medical history and physical exam. In some surgeries, the cyst is drained, removed and closed with stitches. In other surgeries, the cyst is drained and removed, but the doctor leaves the wound open. This helps the wound heal slowly and makes it less likely for the cyst to come back.

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