Can a cream shrink or close a pilonidal cyst without surgery?

One small study found most people improved after using a polyphenol cream directly on the sinus, but about a third later had it come back, and there was no comparison group, so it's not proven the cream was the cause.

Does zinc oxide cream help pilonidal wounds heal faster?

A randomised trial found no significant difference in healing time between zinc oxide cream and a placebo dressing after surgery, though the cream did reduce one type of bacterial infection.

Is manuka honey good for a pilonidal sinus wound?

A small study found most wounds healed with honey used after surgery, but two of seventeen patients had the problem return and one stopped treatment because of a side effect.

Should I stop using a cream on my pilonidal cyst?

There's no evidence that using a cream causes harm, but there's also no reliable evidence it treats the cyst on its own, so don't rely on it instead of seeing a doctor, especially if the area is painful or infected.

What actually treats a pilonidal cyst?

These studies did not compare cream against surgery, so they can't answer that question directly; surgical removal remains the standard, better-studied treatment for a diagnosed pilonidal cyst or sinus.

Can a cream treat a pilonidal cyst or sinus?

Name: Can a cream treat a pilonidal cyst or sinus?
Published: 2026-10-14
Keywords: Cream for a pilonidal cyst?

In patients with a pilonidal cyst or sinus, does treatment with a topical cream (versus no treatment, surgery, or usual wound care) resolve the cyst/sinus, reduce recurrence, or avoid the need for surgery?

Evidence review in plain language · compiled 2026-10-14 · checked 2026-10-14 · next 2026-11-14 · automated review, how it works

Bottom line

There is no solid evidence that a cream alone can treat a pilonidal cyst or sinus.

The only study that applied a cream directly to an unopened pilonidal sinus found that most patients improved, but about a third later had the sinus return, and there was no comparison group, so we can't be sure the cream caused the improvement. Other trials tested creams on open wounds left after surgery, which is a different question from treating the cyst or sinus itself.

How certain

Very low

The only direct evidence is 1 small or uncontrolled study.

What it shows

Unclear

The studies point in different directions.

answers it directly: 1answers it directly
studies found: 12studies found
randomised trials: 3randomised trials
people studied: 806people studied
reviews of trials: 3reviews of trials
years covered: 1987–2024years covered

What the research shows

Resolution or closure of the cyst/sinus
One small, uncontrolled study found 86.5% of patients reported improvement with a polyphenol cream applied to the sinus, but with no comparison group we can't tell how many would have improved anyway.[1]
Insufficient evidence
Recurrence rate at 12 months
The same study found the sinus came back in about a third of patients who had improved, but it did not track recurrence specifically at 12 months, and no other direct study measured this.[1]
Insufficient evidence
Need for subsequent surgical intervention
No study compared cream with surgery to see whether cream could help someone avoid an operation.
Not studied
Wound/sinus healing time
Small trials on wounds left open after surgery give mixed results: some creams (collagenase, Rhizophora bark extract, Lietofix) seemed to speed healing, while zinc oxide cream showed no significant difference versus placebo. These all tested wound care after surgery, not an intact cyst or sinus.[1,2,3,4]
Insufficient evidence
Pain or symptom score
A scoping review found some topical agents may ease wound pain, and a single-patient case report found itching and discomfort resolved after a light-activated cream combined with laser therapy, but this evidence is very weak.[1,2]
Insufficient evidence
Infection or abscess recurrence
Infection or abscess recurrence was not clearly measured across these studies. One retrospective study of polyphenol cream found the sinus returned in about a third of patients (33.3%) and about a quarter (26.6%) had minor, temporary side effects. A trial of zinc oxide cream found no significant difference in wound healing time versus placebo (54 days versus 62 days) and did not report on infection or recurrence. Another study found Staphylococcus aureus infection was common in pilonidal wounds generally but saw no clear evidence of harm from it; that study did not test a cream treatment for pilonidal wounds.[1,2,3]
Insufficient evidence

What it may help with

In small trials on wounds left open after pilonidal surgery, creams such as collagenase, Rhizophora mangle bark extract, or Lietofix appeared to help wounds heal somewhat faster or more completely than the comparison dressing used.[1,2,3]

Important limitations

Only one study tested a cream as a stand-alone treatment for an intact pilonidal cyst or sinus, and it had no comparison group, so we can't tell how many patients would have improved without the cream.[1]
Several of the other studies tested creams or other topical treatments on open wounds left after pilonidal surgery, not on an intact, unopened cyst or sinus, so they only partly address the question asked here.[1,2,3,4,5,6]
The trials are small, ranging from 1 to 205 people, and are mostly rated low or very low quality, with many lacking blinding or a control group.[1,2,3,4,5,6]

What the studies found

Found a benefit4 · 33%
Found no clear effect1 · 8%
Mixed or unclear7 · 58%

What kind of studies

Randomised trial3 · 25%
Narrative review2 · 17%
Systematic review2 · 17%
Retrospective2 · 17%
Meta-analysis1 · 8%
Case series1 · 8%
Prospective cohort1 · 8%

The studies that decided it

Herrod et al. 2022
Dressings and topical agents for the management of open wounds after surgical treatment for sacrococcygeal pilonidal sinus
Cream helped wounds heal after surgeryMeta-analysisLow qualityRelated question
205 people30 days
Lietofix cream increased the proportion of wounds healed by 30 days compared with an iodine dressing, based on one low-certainty study
Who was studied
people with an open wound left after surgery for pilonidal sinus disease
What they received
Lietofix cream applied to the open surgical wound
Compared with
iodine dressing
Main outcome
proportion of wounds healed by 30 days
Quality
This finding comes from a single study rated as low-certainty evidence, with wide confidence intervals, within a review where most studies were at high risk of bias.
Limitations
Based on a single study; no data on time to healing; overall review notes high risk of bias in most included trials and no long-term outcomes like quality of life or recurrence were reported.
Taken word for word from the abstract
- population participants who had undergone any type of sacrococcygeal pilonidal sinus disease surgery and were left with an open wound
- intervention Lietofix cream
- comparator an iodine dressing
- primaryOutcome the proportion of wounds that heal by 30 days
- result Lietofix cream may increase the proportion of wounds that heal by 30 days compared with an iodine dressing (comparison 4; RR 8.06, 95% CI 1.05 to 61.68; 205 participants, 1 study; low-certainty evidence)
- n 205 participants, 1 study
Cochrane Database Syst Rev · PMID 35593897 · Read it on PubMed ↗
Thomas et al. 2011
Manuka honey as an effective treatment for chronic pilonidal sinus wounds
Most healed, one bad reaction.RetrospectiveLow qualityRelated question
17 people2011
15 of 17 patients achieved complete wound healing (mean 65 days); two patients had recurrence after therapy; one patient stopped treatment due to an adverse event
Who was studied
patients with chronic or recurrent pilonidal sinus disease after surgical treatment
What they received
topical manuka honey dressing applied to the wound after surgery
Main outcome
complete wound healing and time to healing, plus recurrence rate
Quality
This was a small, uncontrolled retrospective review of only 17 patients with no comparison group, so results could be due to chance or selection bias.
Limitations
Retrospective design, small sample size, no control group, and honey was used as an adjunct after surgical excision rather than as a standalone treatment for the cyst or sinus.
Taken word for word from the abstract
- population patients who received manuka honey dressing therapy following surgical intervention for chronic or recurrent PSD
- intervention topical manuka honey in the treatment of chronic or recurrent pilonidal sinus disease (PSD)
- primaryOutcome assessing the ability of this simple dressing technique to achieve complete wound healing, the time taken to achieve healing and the recurrence rate
- result 15 patients achieved complete wound healing, in a mean time of 65 days (14-264 days; median 49 days). Honey was discontinued in one patient due to an adverse event, and two patients experienced recurrence several months after completing honey therapy.
- n Seventeen patients were eligible for inclusion in the study.
- harm Honey was discontinued in one patient due to an adverse event
J Wound Care · PMID 22240847 · Read it on PubMed ↗
Aksoy et al. 2010
Effectiveness of topical use of natural polyphenols for the treatment of sacrococcygeal pilonidal sinus disease: a retrospective study including 192 patients
Most improved, but one-third relapsed.RetrospectiveLow quality
192 people22 months
86.5% of patients improved, but the sinus returned in about a third of them and a quarter had minor temporary side effects
Who was studied
people with sacrococcygeal pilonidal sinus disease
What they received
topical polyphenol cream applied to the pilonidal sinus
Compared with
none (no comparison group)
Main outcome
whether patients got benefit from treatment and whether the sinus came back
Quality
This was a retrospective, single-arm study with no comparison group and information partly gathered by phone, so it cannot reliably show the cream works better than nothing.
Limitations
No control group, retrospective design, some data from telephone surveys, possible selection and recall bias.
Taken word for word from the abstract
- population One hundred and ninety two patients with SPSD who used topical polyphenols for the treatment of their disease were studied retrospectively.
- intervention used topical polyphenols for the treatment of their disease
- comparator One hundred and ninety two patients with SPSD who used topical polyphenols for the treatment of their disease were studied retrospectively.
- primaryOutcome One hundred and sixty six (86.5%) patients got benefit from the treatment.
- result One hundred and sixty six (86.5%) patients got benefit from the treatment. Fifty one (26.6%) patients had minor temporary side effects. In 64 (33.3%) patients SPSD relapsed.
- n One hundred and ninety two patients with SPSD who used topical polyphenols for the treatment of their disease were studied retrospectively.
Eur J Dermatol · PMID 20406728 · Read it on PubMed ↗
Agren et al. 2006
A randomized, double-blind, placebo-controlled multicenter trial evaluating topical zinc oxide for acute open wounds following pilonidal disease excision
No faster healing, fewer infectionsRandomised trialModerate qualityRelated question
64 people2006
Median time to complete wound closure was 54 days with zinc oxide versus 62 days with placebo, a difference that was not statistically significant, though zinc oxide reduced Staphylococcus aureus infection and need for antibiotics
Who was studied
adults with open wounds after surgery to remove a pilonidal cyst
What they received
topical 3% zinc oxide cream applied to the wound
Compared with
placebo mesh dressing
Main outcome
time until the wound fully closed
Quality
It was a well-designed double-blind placebo-controlled trial, but with only 64 patients it may have been too small to detect a true difference in healing time.
Limitations
Small sample size; authors state larger trials are needed to show definitive effects on healing and infection.
Taken word for word from the abstract
- population Sixty-four (53 men) consecutive patients, aged 17-60 years
- intervention treatment with 3% zinc oxide (n = 33)
- comparator or placebo (n = 31) by concealed allocation
- primaryOutcome masked assessment of time to complete wound closure
- result Median healing times were 54 days (interquartile range 42-71 days) for the zinc and 62 days (55-82 days) for the placebo group (p = 0.32)
- n Sixty-four (53 men) consecutive patients
Wound Repair Regen · PMID 17014663 · Read it on PubMed ↗
Aldemir et al. 2003
Effectiveness of collagenase in the treatment of sacrococcygeal pilonidal sinus disease
Faster wound healing with creamRandomised trialLow qualityRelated question
40 people2003
Counted as a related question: This study tests collagenase dressing applied after surgical excision and marsupialization, not a cream treatment of the pilonidal cyst or sinus itself as a standalone therapy.
wound healed faster and better in the first two weeks with collagenase dressing (21.9 vs 28.1 days)
Who was studied
people with sacrococcygeal pilonidal sinus disease having surgery
What they received
topical bacterial collagenase dressing applied after excision and marsupialization
Compared with
excision and marsupialization without collagenase dressing
Main outcome
time and quality of wound healing after surgery
Quality
small trial of 40 patients with no mention of blinding or long-term recurrence data, so results may not be reliable.
Limitations
small sample size, no blinding described, recurrence rate not clearly quantified
Taken word for word from the abstract
- population Sacrococcygeal pilonidal sinus disease (SPSD) is a disease affecting young patients
- n 40 patients admitted to our department were separated into two groups
- intervention Excision and marsupialization with dressing by bacterial collagenase was performed in the first group
- comparator the treatment was excision and marsupialization without dressing by bacterial collagenase in the second group
- primaryOutcome the healing in terms of the width and depth of the wound in the first week and in depth of wound in the second week
- result The duration of wound healing was 21.9 +/- 1.3 days in group 1, and 28.1 +/- 1.3 days in group 2 ( P = 0.0001).
Surg Today · PMID 12616370 · Read it on PubMed ↗
Fernandez et al. 2002
Efficacy of Rhizophora mangle aqueous bark extract in the healing of open surgical wounds
Faster wound shrinking after cyst surgeryRandomised trialLow qualityRelated question
37 people6 weeks after surgery
Wounds treated with the bark extract shrank more than those treated with mercurochrome
Who was studied
People recovering from surgery to remove a pilonidal cyst or fistula, with open wounds after the operation
What they received
Topical cream made from Rhizophora mangle bark extract applied once or twice daily to the surgical wound
Compared with
Mercurochrome antiseptic applied twice daily to the wound
Main outcome
Reduction in wound area measured over time after surgery
Quality
Small trial of only 37 people measuring wound size rather than full healing or recurrence, and it treats post-surgical wounds rather than an unremoved cyst or sinus.
Limitations
Small sample size, surrogate outcome of wound area rather than complete healing or recurrence, and the treatment was applied to open wounds after surgical excision rather than to an intact pilonidal cyst or sinus.
Taken word for word from the abstract
- population Thirty-seven patients with open wounds from surgical intervention of pilonidal cyst (14; 37.8%) or pilonidal fistula (23; 62.2%)
- intervention topical treatment with a Rhizophora mangle aqueous bark extract once a day or twice a day
- comparator mercurocrome twice a day
- primaryOutcome measuring the area of the wounds by image digital planimetry
- result The wound areas of the groups treated with the extract once or twice per day showed a greater reduction (P < 0.05) compared to the group treated with mercurocrome.
- n Thirty-seven patients with open wounds
Fitoterapia · PMID 12490213 · Read it on PubMed ↗

All 12 studiesEvery study that answered the question, with its design, size and result.

The other 6 studiesEverything else the search returned, including anything retracted.

Singh et al. 2024
Management of Pilonidal Disease and Hidradenitis Suppurativa
Not addressed for pilonidal disease.Narrative reviewVery low qualityRelated question
size not given2024
The abstract recommends hair removal and surgical options for pilonidal disease, and mentions topical agents only for hidradenitis suppurativa, not for pilonidal disease
Who was studied
people with pilonidal disease or hidradenitis suppurativa
What they received
topical cream for pilonidal cyst or sinus
Compared with
not specified
Main outcome
not specified for pilonidal disease
Quality
This is a general review that does not specifically study or report on topical cream treatment for pilonidal cyst or sinus.
Limitations
The abstract is a broad review covering two different diseases and does not report any study or outcome data on topical cream use for pilonidal disease specifically.
Taken word for word from the abstract
- population Pilonidal disease and hidradenitis suppurativa affect healthy young adults, causing discomfort and pain
- intervention Medical management with topical agents, antibiotics, and biologics should be used initially
- comparator but wide local excision should be considered in severe or refractory cases of the disease.
- result Patients with pilonidal disease should engage in hair removal to the sacrococcygeal region and surgical options considered.
- primaryOutcome Medical management with topical agents, antibiotics, and biologics should be used initially
Surg Clin North Am · PMID 38677816 · Read it on PubMed ↗
Woo et al. 2015
Topical Agents and Dressings for Pilonidal Sinus Wound Healing by Secondary Intention: A Scoping Review
Some dressings may help healing, unprovenSystematic reviewLow qualityRelated question
size not given2015
Some evidence suggests several topical agents (hydrogel, silver, honey, zinc, certain foams, negative pressure therapy, platelet rich plasma, plant extracts) may help healing, reduce bacteria, or ease pain, but evidence is limited by weak study quality
Who was studied
People with pilonidal sinus wounds healing after surgery (secondary intention)
What they received
Various topical agents and dressings (hydrogel, silver, honey, zinc, foam, PRP, plant extracts, NPWT)
Compared with
Different topical agents and dressings compared to each other
Main outcome
Wound healing, bacterial burden, and wound pain
Quality
This is a scoping review of mostly small, methodologically weak studies, so the findings are only suggestive, not proven.
Limitations
The abstract states evidence remains insufficient due to methodological limitations and biases in the underlying studies, and this covers wound care after surgery rather than treating an unopened cyst or sinus.
Taken word for word from the abstract
- population to examine which topical agent or dressing is effective in promoting pilonidal wound healing by secondary intention
- intervention topical applications of hydrogel, silver, honey, zinc, selected foam materials, negative pressure wound therapy, platelet rich plasma, and plant extracts
- comparator Topical treatment using polyhexamethylene biguanide and silver may be beneficial in reducing bacterial burden
- primaryOutcome examine which topical agent or dressing is effective in promoting pilonidal wound healing by secondary intention
- result there is some evidence to suggest that topical applications of hydrogel, silver, honey, zinc, selected foam materials, negative pressure wound therapy, platelet rich plasma, and plant extracts may promote wound healing
Surg Technol Int · PMID 26054992 · Read it on PubMed ↗
Harris et al. 2012
Development of an evidence-based protocol for care of pilonidal sinus wounds healing by secondary intent using a modified reactive Delphi procedure. Part one: the literature review*
No evidence reported either way.Narrative reviewVery low qualityRelated question
size not given2012
No best practice guidelines were found; the review only identified topics (including topical antiseptics/antimicrobials) for later development of a questionnaire, without reporting any outcome data on creams
Who was studied
People with pilonidal sinus wounds healing by secondary intent
What they received
Topical antiseptics or antimicrobials (mentioned as one of many topics)
Main outcome
Whether evidence-based guidelines exist for care of these wounds
Quality
This is a literature review describing gaps in guidance and listing topics for future study, not a study testing a cream's effectiveness.
Limitations
The abstract does not test any specific cream or report outcomes; it only lists topical antiseptics/antimicrobials as one of seventeen areas needing further consensus.
Taken word for word from the abstract
- population pilonidal sinus wounds (PSW) healing by secondary intent
- intervention role of topical antiseptics or antimicrobials
- primaryOutcome to determine if an evidence-based guideline or consensus document existed for the care of these wounds
- result The review found no best practice guidelines concerning PSW, and only one clinical pathway.
- result Seventeen areas of interest were identified that may contribute to optimal healing conditions or to delayed healing.
Int Wound J · PMID 21999659 · Read it on PubMed ↗
Saraceno et al. 2009
Methyl aminolaevulinate photodynamic therapy for the treatment of hidradenitis suppurativa and pilonidal cysts
Big improvement, but cream was combined with light therapy.Case seriesVery low qualityRelated question
1 people6 months
almost complete clearing of lesions (80%) and complete resolution of itching and discomfort after 6 months
Who was studied
a man with hidradenitis suppurativa and pilonidal cysts since age 21
What they received
a light-activated cream (MAL) applied to the skin plus laser/light therapy, repeated every 15 days for nine sessions
Compared with
none (single patient, before-and-after)
Main outcome
improvement in skin lesions and itching/discomfort
Quality
this is a single patient with no comparison group, and the cream was combined with light therapy so the cream's own effect can't be separated out.
Limitations
only one patient was treated, there was no control group, and the treatment combined the cream with light-based photodynamic therapy rather than testing the cream alone.
Taken word for word from the abstract
- population a 29-year-old man affected by HS and pilonidal cysts since the age of 21
- intervention A topical MAL cream (Metvix) was applied to the affected areas with an occlusive dressing for 3 h and irradiated with a red light source. Therapy was repeated every 15 days for a total of nine applications.
- comparator We report the case of a 29-year-old man
- primaryOutcome achieved an almost complete clinical remission of the skin lesions (80%) and complete resolution of the itching and discomfort
- result The patient completed a 6-month follow-up and achieved an almost complete clinical remission of the skin lesions (80%) and complete resolution of the itching and discomfort.
- n We report the case of a 29-year-old man
Photodermatol Photoimmunol Photomed · PMID 19438999 · Read it on PubMed ↗
O'Meara et al. 2001
Systematic review of antimicrobial agents used for chronic wounds
Doesn't specifically test cream for pilonidal sinusSystematic reviewLow qualityRelated question
size not given2001
the review found systemic antibiotics may help as an addition to surgery for pilonidal sinuses, and some topical preparations may help chronic wounds generally, but it does not specifically report a result for topical cream used alone on pilonidal cysts or sinuses
Who was studied
people with chronic wounds including leg ulcers, diabetic foot ulcers, and pilonidal sinuses
What they received
topical antimicrobial preparations (various, not specific to pilonidal sinus)
Main outcome
wound healing
Quality
this is a narrative review of mostly small trials with methodological problems, and it does not specifically test cream for pilonidal sinus, so it cannot answer this question directly.
Limitations
Small sample size and other methodological problems meant that findings were often difficult to interpret.
Taken word for word from the abstract
- population recruited participants with chronic wounds
- intervention Several topical preparations may be helpful, including dimethyl sulphoxide, silver sulphadiazine, benzoyl peroxide, oxyquinoline and gentamicin.
- primaryOutcome incorporated an objective assessment of wound healing
- result Results do not support the routine use of systemic antibiotics for leg ulcers or diabetic foot ulcers without acute infection, but they may be useful as an adjunct to surgery for pilonidal sinuses.
- result Several topical preparations may be helpful, including dimethyl sulphoxide, silver sulphadiazine, benzoyl peroxide, oxyquinoline and gentamicin.
- limitations Small sample size and other methodological problems meant that findings were often difficult to interpret.
Br J Surg · PMID 11136304 · Read it on PubMed ↗
Marks et al. 1987
Staphylococcal infection of open granulating wounds
Not tested as pilonidal treatment.Prospective cohortLow qualityRelated question
250 people1987
the cream was used for infected armpit wounds and worked well there, but it was not used to treat the pilonidal sinus wounds; in the pilonidal group, infection with the bacteria was common but there was no clear evidence it caused harm
Who was studied
people with wounds healing openly after surgery, including pilonidal sinus removal, armpit skin removal, and abdominal surgery
What they received
Fucidin (fusidic acid) antibiotic ointment, used to treat infected armpit wounds
Compared with
no specific comparator for pilonidal sinus wounds; outcome compared across wound types
Main outcome
whether Staphylococcus aureus infection caused pain and delayed healing
Quality
this was an observational study of infection patterns, not a trial testing a cream on pilonidal sinus wounds specifically.
Limitations
the cream treatment was only applied to and described for the armpit wound group, not the pilonidal sinus group, so this does not test cream treatment for pilonidal cysts or sinuses.
Taken word for word from the abstract
- population 250 wounds healing by open granulation
- population 150 pilonidal sinus excisions studied
- intervention The infections responded well to Fucidin ointment.
- n 250 wounds
- primaryOutcome 17 became infected with Staphylococcus aureus with consequent pain and delay in healing
- result there was no clear evidence of harm resulting in the 50 laparotomy wounds and 150 pilonidal sinus excisions studied
- comparator although S. aureus was not infrequently found in deep granulating wounds, there was no clear evidence of harm
Br J Surg · PMID 3815041 · Read it on PubMed ↗

How we searchedThe exact query, the date it ran, and what came back — so you can run it yourself.

Searched: PubMed · ClinicalTrials.gov · Crossref on 2026-10-14
The exact search — paste this into PubMed to repeat it: "Pilonidal Sinus"[Mesh] AND ("Ointments"[Mesh] OR "Administration, Topical"[Mesh] OR cream[tiab] OR creams[tiab] OR topical[tiab] OR ointment[tiab]); PubMed expanded that to: "Pilonidal Sinus"[MeSH Terms] AND ("Ointments"[MeSH Terms] OR "administration, topical"[MeSH Terms] OR "cream"[Title/Abstract] OR "creams"[Title/Abstract] OR "topical"[Title/Abstract] OR "ointment"[Title/Abstract])
What came back: 38 records found · 38 read · 12 answered the question
Included: Human, animal or laboratory studies reporting an outcome relevant to the question
Excluded: Records about a different condition or intervention
Studies of phenol (crystallized or liquid) treatment — a different treatment from the one asked about
Records reporting no outcome
Retracted publications, which are listed but excluded from every count
Limits: Details were read from abstracts, not full papers, so anything reported only in a paper's methods section is not captured here.
Fields were read from abstracts, not full text, so detail reported only in a paper's methods section is not captured.
Evidence strength is adapted from the GRADE framework. It is not a GRADE assessment and was not produced by a GRADE panel.

38records came back from the search
38were read
12actually answered the question

Risks and safetyReported side effects and who should be careful.

In the one study that applied a polyphenol cream directly to the sinus, about a quarter of patients had minor, temporary side effects.
In a small study of manuka honey used on wounds after surgery, one of seventeen patients stopped treatment because of an adverse reaction.

Why people try itThe reasoning behind the question — not a claim that it works.

Hoping to avoid the pain, cost, or downtime of surgery.
Creams are easy to buy and apply at home without seeing a doctor.
Online claims that natural or herbal creams can clear a cyst without a procedure.
Fear of scarring or recurrence after a surgical operation.

Common questionsShort answers, drawn from the same studies.

Can a cream shrink or close a pilonidal cyst without surgery?: One small study found most people improved after using a polyphenol cream directly on the sinus, but about a third later had it come back, and there was no comparison group, so it's not proven the cream was the cause.
Does zinc oxide cream help pilonidal wounds heal faster?: A randomised trial found no significant difference in healing time between zinc oxide cream and a placebo dressing after surgery, though the cream did reduce one type of bacterial infection.
Is manuka honey good for a pilonidal sinus wound?: A small study found most wounds healed with honey used after surgery, but two of seventeen patients had the problem return and one stopped treatment because of a side effect.
Should I stop using a cream on my pilonidal cyst?: There's no evidence that using a cream causes harm, but there's also no reliable evidence it treats the cyst on its own, so don't rely on it instead of seeing a doctor, especially if the area is painful or infected.
What actually treats a pilonidal cyst?: These studies did not compare cream against surgery, so they can't answer that question directly; surgical removal remains the standard, better-studied treatment for a diagnosed pilonidal cyst or sinus.

What has changedEvery re-check, and whether it changed the answer.

2026-10-14
Re-reviewed under a revised method: question type, study relevance and the harm rule. 3 new studies · 17 no longer retrieved · evidence strength moderate → very low · conclusion no meaningful benefit → unclear.
How certain we are changed. The conclusion changed.

This is information, not advice

This page summarises published research. It cannot tell you what is happening in your own body, and evidence changes. If something is bleeding, painful, or new, it is worth being looked at — that is a different question from the one on this page, and a better one to bring to a consultation.

Contact the office

Automated evidence review — PubMed, ClinicalTrials.gov, Crossref. Search strategy, grading rules and the checks that must pass before anything publishes were written by Allen Kamrava, MD, MBA, FACS, FASCRS, colon & rectal surgery, Beverly Hills. The pages themselves are compiled by software running that method and are not read one by one before publication — saying otherwise would be the one claim here that could not be checked.

Allen Kamrava, MD, MBA, FACS, FASCRS · 435 N. Bedford Dr., Suite 308, Beverly Hills, CA 90210 · 424.279.8222

Educational information — not medical advice.