Is a pilonidal cyst dangerous in pregnancy?

No study in this review followed pregnant people with a pilonidal cyst, so there's no research-based answer specific to pregnancy. If you're pregnant and have a painful or draining cyst, tell your obstetric provider so it can be checked and treated like any other infection.

Is an infected pilonidal cyst dangerous?

An infected cyst (abscess) usually needs drainage and sometimes antibiotics; studies show this is a common complication rather than a typical life-threatening one. In rare, documented cases the infection has spread more seriously, including toward the spine or abdomen, so worsening pain, fever, or feeling very unwell needs prompt medical attention.

What should I do instead of waiting it out?

See a doctor or urgent care rather than trying to drain it yourself; abscesses are usually treated with incision and drainage, sometimes with antibiotics. Watch for spreading redness, fever, or feeling unwell, since case reports show an untreated spreading infection can occasionally become serious.

Can a pilonidal cyst turn into cancer?

Yes, but it's very rare. In the largest study to look at this, cancer was found in only about 1 in 800 removed chronic cysts, almost always after the cyst had been present for many years.

Is a pilonidal cyst dangerous?

Name: Is a pilonidal cyst dangerous?
Published: 2026-10-13
Keywords: is pilonidal cyst dangerous, is pilonidal cyst dangerous in pregnancy, is an infected pilonidal cyst dangerous

In people with a pilonidal cyst or sinus (including during pregnancy), what is the risk of serious complications such as abscess formation, systemic infection, or (rarely) malignant transformation if the cyst is left untreated or recurs?

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Evidence review in plain language · compiled 2026-10-13 · checked 2026-10-13 · next 2026-11-13 · automated review, how it works

Bottom line

A pilonidal cyst or sinus can sometimes lead to real complications — repeat abscesses, infection, or in rare cases surgery-related skin cancer — but the evidence for how often this happens comes only from observational studies, not controlled trials.

Recurrence or re-operation rates after surgery for pilonidal abscess or sinus vary widely across cohort studies, from about 9% needing a repeat procedure within a year in one study of 1,932 patients to 27–34% having recurrence or complications in another, and roughly one third needing another operation within five years after initial drainage of an abscess. Cancer arising from long-standing pilonidal disease is rare — found in 2 of 1,505 patients (0.13%) having surgical removal in the largest series, more often in people over 40 or with cysts present more than three years, and both of those patients were cancer-free two years later. Common bacteria found in infected abscesses include anaerobic organisms and Streptococcus anginosus, but no clear risk factors for recurrence have been identified, and none of these studies focused specifically on pregnancy.

How certain

Low

Only observational evidence addresses this question (4 studies).

What it shows

Signal of harm

15 studies reported harm or tissue damage, including laboratory evidence.

studies found: 63studies found
randomised trial: 1randomised trial
people studied: 16,704people studied
reviews of trials: 2reviews of trials
years covered: 2013–2026years covered

Read this first

An abscess (a pocket of pus) can form at the cyst site, sometimes needing urgent drainage or repeat surgery.
Rarely, infection from the area has spread to cause severe illness, including toxic-shock-like illness needing intensive care, an abscess tracking toward the spine, and a case of infection perforating into the abdomen.
Very rarely, a long-standing pilonidal sinus turns into squamous cell carcinoma, a type of skin cancer; when this happens it can spread and be fatal.
Surgery to remove a pilonidal cyst carries its own risk: in one large study, about 5 in 100 patients had a major complication and 8 in 100 needed repeat surgery within a year.

What the research shows

Rate of abscess formation or acute infection
Cohort studies of people with pilonidal disease show abscess and infection are common complications, sometimes needing repeat drainage or surgery.[1,2,3,4]
Possible harm
Rate of systemic sepsis or hospitalization
Case reports describe rare instances of severe spreading infection — toxic shock, a spinal epidural abscess, and infection perforating into the abdomen — arising from pilonidal disease, though how often this happens is unknown.[1,2,3]
Possible harm
Recurrence rate after conservative vs surgical management
Recurrence rates after various surgeries range widely, from about 3% to a third of patients, but no study compared surgery directly against leaving the cyst untreated, so the added risk of not treating isn't measured.[1,2,3,4,5,6,7]
Insufficient evidence
Rate of malignant transformation (e.g. squamous cell carcinoma) in chronic pilonidal sinus
In the largest study of pilonidal surgery patients, cancer was found in 2 of 1,505 removed chronic cysts (0.13%, about 1 in 750), usually after many years of disease, and both of those patients were cancer-free two years later. Smaller case reports and series describe more aggressive outcomes, including cancers that spread and were fatal, with survival dropping as cancer stage or tumour grade worsens.[1,2,3,4,5,6,7,8,9]
Possible harm
Pregnancy-specific complication rates
No study in this review followed pregnant people with a pilonidal cyst or measured outcomes specific to pregnancy.
Not studied
Need for emergency surgical intervention
Acute abscesses sometimes require urgent incision and drainage, and isolated case reports describe emergency surgery for rare complications such as perforation into the abdomen.[1,2,3]
Possible harm

What it may help with

Cancer developing from a pilonidal cyst is rare: in the largest study that checked, only about 1 in 800 removed cysts contained cancer.[1]
When an abscess does form, standard drainage or surgical care led to healing in most people across several case series.[1,2,3,4,5,6,7]

Important limitations

Much of the evidence for serious complications (spreading infection, cancer, death) comes from single case reports describing one patient each, which cannot say how often these events actually happen.[1,2,3,4,5,6,7,8,9,10,11]
The large cohort studies followed people who already had surgery, not people who left the cyst untreated, so they can't show what happens with no treatment at all.[1,2,3]
Studies define 'serious complication' differently — some count any repeat procedure, others count only major infection — which makes the reported rates hard to compare directly.[1,2,3,4]

What the studies found

Found a benefit16 · 25%
Found no clear effect2 · 3%
Mixed or unclear30 · 48%
Found possible harm15 · 24%

What kind of studies

Case series29 · 46%
Retrospective17 · 27%
Narrative review9 · 14%
Prospective cohort3 · 5%
Registry1 · 2%
Randomised trial1 · 2%
Guideline1 · 2%
Systematic review1 · 2%
Meta-analysis1 · 2%

The studies that decided it

Garcia et al. 2026
Patient characteristics and microbiology in pilonidal abscesses in children
Abscesses common; no recurrence risk factors foundRetrospectiveLow quality
154 people2026
anaerobic bacteria and Streptococcus anginosus group were the most common organisms found, and no factors linked to recurrence were identified
Who was studied
children who had pilonidal abscesses
What they received
none - observational study describing abscess microbiology and characteristics
Compared with
none
Main outcome
types of bacteria found in abscesses and risk factors for recurrence
Quality
this is a descriptive chart review from one hospital with no comparison group, so it can't show whether treatments work or how dangerous the condition is.
Limitations
single tertiary pediatric center, retrospective design, no control group
Taken word for word from the abstract
- n 216 pilonidal abscess episodes among 154 children
- population 216 pilonidal abscess episodes among 154 children over a 10-year period at a tertiary pediatric center
- intervention We described the microbiology of 216 pilonidal abscess episodes among 154 children
- comparator We described the microbiology of 216 pilonidal abscess episodes among 154 children over a 10-year period at a tertiary pediatric center and assessed patient characteristics associated with recurrence.
- primaryOutcome assessed patient characteristics associated with recurrence
- result Anaerobes and Streptococcus anginosus group were the most common organisms isolated from surgical cultures. No risk factors for recurrence were identified.
J Pediatric Infect Dis Soc · PMID 41454773 · Read it on PubMed ↗
Faurschou et al. 2025
Risk of re-operation after incision and drainage for acute, abscess-forming pilonidal sinus disease: A Danish population-based cohort study
Most didn't need more surgeryRegistryModerate qualityRelated question
8,251 peoplefive-year
about one third of patients needed a repeat operation within five years, with higher risk in younger patients, females, and those with a family history
Who was studied
patients diagnosed with acute abscess-forming pilonidal sinus disease
What they received
incision and drainage surgery for the abscess
Compared with
none - single treatment cohort followed over time
Main outcome
risk of needing another operation for pilonidal disease
Quality
it is a large nationwide registry study, but it only tracks outcomes after surgery rather than comparing treatments or addressing danger of the disease itself
Limitations
abstract does not describe how complications or severity of the original abscesses were assessed, and relies on registry data
Taken word for word from the abstract
- n Of 8251 (62% male) patients included
- population patients diagnosed with abscess-forming PSD undergoing lateral I&D as the initial treatment for PSD
- intervention lateral incision and drainage (I&D) considered the gold standard
- comparator Patients were followed up until re-operation, death, emigration, or the end of the study period.
- primaryOutcome To evaluate re-operation rates following abscess-forming PSD treatment with lateral I&D
- result The overall five-year CIF was 32% for males and 33% for females.
Colorectal Dis · PMID 41239746 · Read it on PubMed ↗
Kudaş et al. 2025
Pathological Examination in Pilonidal Sinus Surgery: Evaluating Necessity and Cost-Effectiveness: A 10-Year Retrospective Analysis
Cancer in pilonidal cysts is very rare.RetrospectiveLow quality
1,505 people2-year follow-up
Only 2 of 1505 patients (0.13%) had cancer in the removed tissue; being over 40 and having the cyst for more than 3 years raised the risk
Who was studied
patients who had surgery to remove a pilonidal sinus/cyst
What they received
surgical removal of the pilonidal sinus with tissue sent for pathology testing
Compared with
no separate comparison group; all removed tissue examined for cancer
Main outcome
how often cancer (squamous cell carcinoma) was found in the removed tissue
Quality
This is a retrospective chart review with no control group and excluded incomplete records, which can bias the results.
Limitations
Retrospective design, patients with incomplete pathology data were excluded without replacing the missing information.
Taken word for word from the abstract
- n A retrospective analysis was conducted on 1505 patients who underwent surgical excision of PSD
- population patients who underwent surgical excision of PSD between January 1, 2014, and December 31, 2023
- intervention All specimens underwent histopathological examination to detect malignancies
- comparator All specimens underwent histopathological examination to detect malignancies
- primaryOutcome This study aims to assess the incidence of malignancy in PSD
- result Two cases (0.13%) of SCC were identified, both in males aged 50 and 58 years
- followUp both patients being disease-free at the 2-year follow-up
Am Surg · PMID 39544170 · Read it on PubMed ↗
Couto-González et al. 2022
Neoplastic degeneration of chronic sacrococcygeal pilonidal sinus: report of seven cases and literature review
Rare but sometimes fatal cancer complication.Case seriesVery low quality
7 people70.5 months
patients with ulcerative tumors had nerve and deep tissue invasion and lymph node spread and died after about 7 months, while patients with exophytic tumors had no invasion and all survived over an average of 70.5 months
Who was studied
men with long-standing pilonidal sinus disease who developed cancer at the site
What they received
no treatment tested; study looked at tumor growth pattern (ulcerative vs exophytic) in cases of cancer arising from pilonidal sinus
Compared with
ulcerative tumor pattern compared with exophytic tumor pattern
Main outcome
survival and spread of the cancer depending on tumor growth pattern
Quality
this is a small retrospective review of only seven patients with no comparison group, so it can only show that this rare complication happens, not how often.
Limitations
retrospective design, very small number of cases, single institution, long and variable follow-up
Taken word for word from the abstract
- n Seven male patients with a mean age at diagnosis of 64.8 years old were collected.
- population patients diagnosed of malignization of PS in our institution from 2000 to 2019
- intervention The patients presenting an ulcerative pattern in the primary tumor showed in all the cases perineural invasion, local deep structures infiltration, and neoplastic dissemination to the regional lymph nodes.
- comparator patients with exophytic patterns in the primary tumor did not present local invasion or regional nodes affectation
- primaryOutcome We pretend to determine the factors that influence in the prognosis of the neoplastic disease assessing clinical features and histological findings.
- result All these patients died in an average time of 7 months.
- result All the cases survive with an average follow-up of 70.5 months.
- followUp average follow-up of 70.5 months
Cir Cir · PMID 35636935 · Read it on PubMed ↗
López et al. 2018
High Rate of Major Morbidity after Surgical Excision for Pilonidal Disease
Surgery often causes complications or recurrence.RetrospectiveLow quality
1,932 peopleone year
4.7% had a major complication, 8.0% needed repeat surgery, 8.7% had either within a year
Who was studied
patients with pilonidal disease undergoing initial surgical excision
What they received
surgical excision of pilonidal disease
Main outcome
major surgical site complication or need for repeat surgery within one year
Quality
This is a retrospective database study without a comparison treatment group, so it shows complication rates but cannot prove cause or compare to other options.
Limitations
Retrospective design using administrative hospital data, no comparator group, risk factors not controllable for all confounders.
Taken word for word from the abstract
- population Patients with pilonidal disease who had initial excision procedures between 2011-2013
- intervention Surgical resection is often performed to prevent recurrence of disease
- primaryOutcome the composite outcome of major surgical site complication or surgical re-excision within one year
- result 4.7% (n = 138) had a major surgical site complication, 8.0% (n = 154) had a surgical re-excision, and 8.7% experienced either event within one year of their initial excision
- n Of the 1,932 patients included
Surg Infect (Larchmt) · PMID 29870307 · Read it on PubMed ↗
Oliveira et al. 2018
Teenage boy with high fever and rash: what could we be missing?
Pilonidal abscess caused severe shock.Case seriesVery low quality
1 people4 days
Pilonidal abscess caused severe infection with dangerously low blood pressure requiring intensive care, resolved after drainage and antibiotics
Who was studied
A 15-year-old boy with high fever and rash
What they received
No intervention being tested; case report of illness and treatment received
Main outcome
Severe illness (toxic shock-like syndrome) linked to pilonidal abscess
Quality
This is a single patient case report, so it cannot show how often this happens or to whom.
Limitations
Single case, no control group, cannot establish how common this complication is
Taken word for word from the abstract
- population A 15-year-old boy was admitted to a local hospital with high fever, generalised rash and a mild sore throat.
- n A 15-year-old boy was admitted
- primaryOutcome develops a sustained low diastolic blood pressure (DBP), unresponsive to fluid volume expansion and cardiovascular support with dopamine
- intervention He was started on intravenous flucloxacillin
- result A sacrococcygeal pilonidal abscess was identified, requiring prompt surgical drainage.
- result He was free of symptoms after 4 days.
- result This case report summarises a potential severe complication of the pilonidal disease.
BMJ Case Rep · PMID 29437816 · Read it on PubMed ↗
Fitzpatrick et al. 2014
Pilonidal disease in a military population: how far have we really come?
High recurrence and complication rates after surgery.RetrospectiveLow quality
151 people2014
27.2% of patients had recurrence and 34.4% had complications after surgery, with higher complication risk after excision with primary closure
Who was studied
military personnel who had surgery for pilonidal disease
What they received
surgical excision, excision with closure, or incision and drainage for pilonidal disease
Compared with
different surgical methods compared to each other
Main outcome
disease recurrence and complications after surgery
Quality
this is a retrospective single-center study without randomization, so it mainly shows how risky surgery was in this group, not a controlled comparison
Limitations
retrospective design, single institution, no control group without surgery, potential confounding by race and disease severity
Taken word for word from the abstract
- population A total of 151 patients with PD were identified
- intervention excision (45.7%), excision with primary closure (29.8%), and incision and drainage (9.9%)
- comparator excision with primary closure was associated with increased complications
- primaryOutcome the primary outcomes of recurrence and morbidity
- result Overall recurrence and morbidity rates were 27.2% and 34.4%, respectively.
- n A total of 151 patients with PD were identified
Am J Surg · PMID 24239526 · Read it on PubMed ↗

What actually helps, on this site

More about the condition:

Perianal Abscess

All 63 studiesEvery study that answered the question, with its design, size and result.

The other 56 studiesEverything else the search returned, including anything retracted.

Sie et al. 2026
Hidradenitis Suppurativa: Part of a Tetrad of Follicular Occlusion Disorders
Pilonidal sinus linked to chronic inflammation.Narrative reviewVery low qualityRelated question
size not given2026
the review describes pilonidal sinus as part of a group of chronic inflammatory conditions causing abscesses, sinus tracts, scarring and psychosocial impact, without a specific outcome measurement for pilonidal cysts
Who was studied
people with follicular occlusion disorders, including pilonidal sinus
What they received
wound care strategies for follicular occlusion disorders
Main outcome
disease characteristics, mechanisms and management of follicular occlusion disorders
Quality
This is a general narrative review for clinician education, not a study measuring outcomes, so it cannot show whether pilonidal cysts are dangerous.
Limitations
No original data, no control group, and pilonidal sinus is only one of four conditions discussed with most detail given to hidradenitis suppurativa.
Taken word for word from the abstract
- population this grouping includes hidradenitis suppurativa (HS), acne conglobata (AC), dissecting cellulitis of the scalp (DCS), and pilonidal sinus (PS)
- intervention This article outlines evidence-informed wound care strategies for both nonsurgical and postsurgical presentations
- primaryOutcome To increase clinicians' understanding of follicular occlusion disorders including the associated risk factors, clinical manifestations, and evidence-based approaches for management.
- result follicular hyperkeratosis leading to occlusion, rupture, and subsequent abscess or sinus tract formation
- result frequently resulting in scarring, lymphedema, and significant psychosocial impairment
Adv Skin Wound Care · PMID 42759045 · Read it on PubMed ↗
Türker Çolak et al. 2026
Laser-assisted endoscopic treatment of pilonidal sinus disease in children: a first pediatric series
High cure rate, minimal pain treatmentCase seriesLow qualityRelated question
45 people32.4 ± 11.3 months
91.1% of patients were cured after one procedure, and all were eventually cured with minimal pain
Who was studied
children under 18 years old with pilonidal sinus disease
What they received
laser-assisted endoscopic treatment of the pilonidal sinus (LEPSIT)
Compared with
none reported (no comparison group)
Main outcome
successful treatment and pain levels after the procedure
Quality
This was a retrospective study of a small group with no comparison group, so it mainly shows this treatment works well but cannot tell us how dangerous the condition itself is.
Limitations
Retrospective design, no control/comparator group, single-center experience
Taken word for word from the abstract
- population Clinical data of children under 18 years of age who underwent LEPSIT for PSD
- intervention laser-assisted endoscopic pilonidal sinus treatment (LEPSIT)
- comparator RESULTS: Of the 45 patients included
- primaryOutcome Successful treatment was achieved in 41 patients (91.1%) after a single procedure
- result Successful treatment was achieved in 41 patients (91.1%) after a single procedure; 4 patients (8.9%) had recurrence, all of whom achieved cure after a second LEPSIT. Improvement was ultimately achieved in all 45 patients.
- n Of the 45 patients included, 19 (42.2%) were female, and 26 (57.8%) were male
Pediatr Surg Int · PMID 42560577 · Read it on PubMed ↗
Acar et al. 2026
Treatment Outcomes of Presacral Pilonidal Sinus Disease Using Crystallised Phenol: A Single-Centre Clinical Series
Some abscess and recurrence after treatment.Case seriesLow qualityRelated question
40 people3 months
Treatment-related abscess developed in 12.5% (5/40) and recurrence during the 3-month follow-up was observed in 12.5% (5/40); all such events occurred in the three-session group
Who was studied
patients with presacral pilonidal sinus disease treated at a single centre
What they received
crystallised phenol treatment (2 or 3 sessions)
Compared with
two-session versus three-session phenol treatment groups
Main outcome
number of treatment sessions needed, and rates of treatment-related abscess and recurrence
Quality
This is a small, single-centre case series without a control group and only short-term follow-up, so it cannot show how dangerous the disease itself is.
Limitations
Single-centre, no untreated comparison group, short follow-up (3 months), and the abstract itself calls for larger studies with longer follow-up.
Taken word for word from the abstract
- n Consecutive patients treated with crystallised phenol were analysed (n = 40).
- population patients with presacral pilonidal sinus disease managed with crystallised phenol in a single-centre clinical series
- intervention crystallised phenol
- comparator Comparisons between the two-session and three-session groups were performed with the Mann-Whitney U test for continuous variables and Fisher's exact test for categorical variables.
- primaryOutcome relationship between pit burden and session requirement
- result Treatment-related abscess developed in 12.5% (5/40), and recurrence during the 3-month follow-up was observed in 12.5% (5/40); notably, all such events occurred in the three-session group (0/17 vs. 5/23, p = 0.061 for both comparisons).
Int Wound J · PMID 42165106 · Read it on PubMed ↗
Chen et al. 2025
[Treatment options for different types of sacrococcygeal pilonidal disease]
Discusses treatment options, not danger.Narrative reviewVery low qualityRelated question
size not given2025
the article summarizes which treatment strategy fits which type/severity of pilonidal disease, without giving a single quantitative outcome
Who was studied
people with sacrococcygeal pilonidal disease (a cyst/abscess near the tailbone)
What they received
different surgical techniques (drainage, minimally invasive procedures, excision, flap surgery)
Compared with
non-surgical treatment versus various surgical approaches
Main outcome
which treatment best reduces recurrence and complications for different disease severities
Quality
this is a narrative review based on clinical experience and prior literature, not a controlled study with measured outcomes.
Limitations
it is a non-systematic review discussing treatment choices rather than a study measuring how dangerous the disease itself is, and reports no patient numbers or outcome data.
Taken word for word from the abstract
- population sacrococcygeal pilonidal disease (SPD)
- intervention Various surgical techniques have been employed for the treatment of SPD
- comparator Non-surgical treatment is suitable for asymptomatic SPD patients.
- primaryOutcome An ideal treatment plan for SPD should be simple to perform, reduce recurrence rates, enable patients to quickly return to normal daily activities, and be associated with a low incidence of complications.
- result this article summarizes the treatment strategies for different types of SPD, providing a reference for clinicians in formulating diagnosis and treatment plans.
Zhonghua Wei Chang Wai Ke Za Zhi · PMID 41397831 · Read it on PubMed ↗
Yung et al. 2026
Connecting polycystic ovary syndrome and pilonidal disease in adolescents: State of the art review
Linked to PCOS in teen girls.Narrative reviewVery low qualityRelated question
size not given2026
the two conditions share risk factors such as obesity, hyperandrogenism, and metabolic syndrome, and the review recommends a shared management pathway
Who was studied
female teenagers with pilonidal disease or polycystic ovary syndrome
What they received
none (this is a review discussing disease association, not a treatment)
Main outcome
association between polycystic ovary syndrome and pilonidal disease
Quality
this is an opinion-based review summarizing an association, not a study that tested dangerousness or treatment outcomes.
Limitations
no original data, sample size, or outcome measures are reported; it is a narrative/clinical opinion piece.
Taken word for word from the abstract
- population female adolescents who may be suffering from either polycystic ovary syndrome or pilonidal disease
- primaryOutcome a recently reported association between polycystic ovary syndrome and pilonidal disease within the female adolescent population
- result The conditions share common risk factors such as obesity, hyperandrogenism, and metabolic syndrome.
- intervention This clinical opinion suggests a reciprocal pathway for management of female adolescents who may be suffering from either polycystic ovary syndrome or pilonidal disease, with the goal of providing comprehensive management and mitigating morbidity.
Best Pract Res Clin Obstet Gynaecol · PMID 41337870 · Read it on PubMed ↗
Stoeckel et al. 2025
Gender Differences in Adolescent Pilonidal Disease
Disease is uncomfortable, not life-threatening.RetrospectiveLow qualityRelated question
1,356 people2025
females had earlier disease onset, lower disease severity, but greater quality of life impact than males, despite similar tolerance of treatments
Who was studied
adolescents with pilonidal disease, by gender
What they received
female gender (comparison of disease characteristics and treatment)
Compared with
male gender
Main outcome
disease severity, quality of life impact, and treatment outcomes by gender
Quality
This is a retrospective cohort study comparing genders, not evaluating danger or complications of the disease itself, so it offers limited direct evidence on how dangerous pilonidal cysts are.
Limitations
Retrospective design; focuses on gender differences in disease presentation and quality of life rather than directly assessing disease danger or complication rates.
Taken word for word from the abstract
- n Of 1356 patients with pilonidal disease, 562 (41 %) were female and 794 male.
- population Pilonidal disease is a common, disruptive condition in adolescents.
- intervention We studied the effects of pilonidal disease on adolescents by gender.
- comparator We studied the effects of pilonidal disease on adolescents by gender.
- primaryOutcome Prospectively collected data on demographics, mental health comorbidities, disease severity, hirsutism, disease-related quality of life impact, interventions, and outcomes were retrieved from a Pilonidal Care Clinic REDCap database and were analyzed by gender.
- result Pilonidal disease has different impacts on females than males including: earlier onset, higher incidence of anxiety, and greater disease-related impact on quality of life, despite lower disease severity on presentation.
J Pediatr Surg · PMID 40086161 · Read it on PubMed ↗
Darnis et al. 2025
Management of pilonidal sinus and recurrences in 2025
Can cause abscess; surgery has real recurrence riskNarrative reviewLow quality
size not given2025
Pilonidal sinus can cause abscess and suppuration requiring emergency drainage, and surgical treatments carry notable risks of recurrence, infection, or failure to heal
Who was studied
people with pilonidal sinus disease
What they received
surgical and non-surgical treatments for pilonidal sinus
Compared with
different treatment approaches (excision, primary closure, minimally invasive techniques) compared to each other
Main outcome
complications, recurrence, and healing after treatment
Quality
This is a narrative review describing typical management and outcomes without presenting new controlled data or statistics on danger.
Limitations
Narrative review format without systematic methodology or pooled data; does not report specific study numbers or control comparisons.
Taken word for word from the abstract
- population Pilonidal sinus is a common pathology of the intergluteal cleft that can develop into abscess or suppuration.
- intervention Radical excision followed by secondary healing is the most commonly performed option.
- comparator Primary closure after excision can reduce the time for healing and convalescence, but at the cost of more frequent infectious complications.
- primaryOutcome This strategy carries a risk of failure or recurrence for at least 10% of patients.
- result If suppuration and abscess develop, treatment is based either on medical treatment combining analgesics, local antiseptics and sometimes antibiotics, or on emergency incision and drainage in the operating room.
- result This strategy carries a risk of failure or recurrence for at least 10% of patients.
J Visc Surg · PMID 39875233 · Read it on PubMed ↗
Hiremath et al. 2025
Concurrent pilonidal sinus of the nape of the neck and sacrococcygeal region
Rare case, surgery healed both sites.Case seriesVery low qualityRelated question
1 peopleOne year
complete healing with no recurrence one year after surgery
Who was studied
man in his mid-30s with pilonidal sinus abscesses in both the back of the neck and the tailbone area
What they received
surgical removal of the sinus tracts (neck excision and wide local excision with Limberg flap reconstruction for the tailbone area)
Compared with
none
Main outcome
healing and recurrence after surgery
Quality
This is a single patient case report, so it cannot show how often pilonidal cysts cause problems or how risky they generally are.
Limitations
Single case report; extremely rare presentation (concurrent neck and sacrococcygeal sinuses); no comparison group; cannot generalise to typical pilonidal cyst risk.
Taken word for word from the abstract
- n The patient, in his mid-30s, presented with recurrent swelling and discharging sinuses
- population The patient, in his mid-30s, presented with recurrent swelling and discharging sinuses in both the nape of the neck and the intergluteal region.
- intervention The surgical intervention included excision of the sinus tract in the neck and wide local excision with Limberg flap reconstruction in the sacrococcygeal region.
- comparator The surgical intervention included excision of the sinus tract in the neck and wide local excision with Limberg flap reconstruction in the sacrococcygeal region.
- primaryOutcome One year post-surgery, the patient showed complete healing with no recurrence observed during follow-up.
- result One year post-surgery, the patient showed complete healing with no recurrence observed during follow-up.
BMJ Case Rep · PMID 39842887 · Read it on PubMed ↗
Montebello et al. 2024
Parathyroid Hormone Related Protein Mediated Hypercalcaemia Due to Metastatic Squamous Cell Carcinoma Originating from Pilonidal Disease: A Case Report
Rare fatal cancer from pilonidal disease.Case seriesVery low quality
1 people2024
He developed severe hormone-related high calcium levels, his cancer spread widely, and he died within a year of diagnosis
Who was studied
56-year-old man with a long-standing, worsening, painful skin lesion near the tailbone, initially thought to be a pilonidal abscess
What they received
Surgery, radiotherapy, chemotherapy and immunotherapy for cancer that developed from the pilonidal area
Main outcome
Disease progression and survival after diagnosis of cancer arising from pilonidal disease
Quality
This is a single patient case report, so it cannot show how often this happens or what causes it.
Limitations
Only one patient; a case report cannot establish how common this complication is or prove pilonidal disease caused the cancer.
Taken word for word from the abstract
- population A 56-year-old male presented with a longstanding, gradually enlarging, painful, skin lesion over the natal cleft.
- population This was initially thought to be a pilonidal abscess but, following multiple surgeries, he was diagnosed with Stage IVb squamous cell carcinoma of the natal cleft skin with bilateral inguinal lymph node metastases and subcutaneous metastatic deposits.
- intervention He underwent radiotherapy, cisplatin chemotherapy and cemiplimab immunotherapy to control his disease.
- primaryOutcome His course was complicated by severe humoral hypercalcaemia of malignancy (HHM) resistant to medical therapy.
- result His disease progressed, and he developed widespread metastases.
- result He died within a year of diagnosis.
- n A 56-year-old male presented
Br J Hosp Med (Lond) · PMID 39212563 · Read it on PubMed ↗
Singh et al. 2024
Management of Pilonidal Disease and Hidradenitis Suppurativa
Describes treatments, not danger or outcomes.Narrative reviewVery low qualityRelated question
size not given2024
Who was studied
young adults with pilonidal disease or hidradenitis suppurativa
What they received
hair removal and surgical treatment for pilonidal disease; topical agents, antibiotics, biologics, and excision for hidradenitis suppurativa
Quality
This is a general review summarizing management strategies without presenting original data or outcome results, so it offers no evidence for weighing effectiveness or danger.
Limitations
No original data, no outcome measures, no information on complications or danger of pilonidal cysts; purely a management overview.
Taken word for word from the abstract
- population Pilonidal disease and hidradenitis suppurativa affect healthy young adults, causing discomfort and pain that leads to loss of work productivity and should be approached in a personalized manner.
- intervention Patients with pilonidal disease should engage in hair removal to the sacrococcygeal region and surgical options considered.
- intervention Medical management with topical agents, antibiotics, and biologics should be used initially but wide local excision should be considered in severe or refractory cases of the disease.
Surg Clin North Am · PMID 38677816 · Read it on PubMed ↗
Kaba 2024
New factors affecting wound healing and recurrence after pilonidal sinus surgery in adolescents; seborrheic dermatitis and psychiatric co-occurring conditions
Certain conditions linked to worse healing, recurrence.RetrospectiveLow qualityRelated question
282 people2024
patients with seborrheic dermatitis, obesity, or psychiatric diagnoses were more likely to have poor wound healing or recurrence after surgery
Who was studied
adolescents who had surgery for pilonidal sinus disease
What they received
presence of seborrheic dermatitis, obesity, acne, or psychiatric conditions
Compared with
patients without these comorbidities
Main outcome
wound healing problems and recurrence after surgery
Quality
this is a retrospective single-center study without a control group testing a treatment, so it can show associations but not prove cause or treatment benefit
Limitations
retrospective design, single clinic, no comparison of a treatment or prevention strategy
Taken word for word from the abstract
- n We retrospectively analysed 282 adolescent patients operated on in our clinic between 2014 and 2021.
- population 282 adolescent patients operated on in our clinic between 2014 and 2021
- intervention Seborrheic dermatitis, obesity and psychiatric diagnoses showed high statistical association with group 3 and acne with group 4.
- comparator The number of sinuses, abscess presentation and the incidence of comorbid disease in group 1 were found to be statistically significantly lower than all other groups.
- primaryOutcome Our study aimed to examine the effect of comorbidities in addition to the classic known factors that may affect wound complications and recurrence after PSD surgery.
- result In patients with seborrheic dermatitis or psychiatric diagnosis, a significant correlation was found between wound healing according to the type of surgery (p < 0.05).
Int Wound J · PMID 37722760 · Read it on PubMed ↗
Safadi et al. 2023
Pilonidal sinus disease carcinoma: Survival and recurrence analysis
Rare cancer form has poor survivalRetrospectiveLow qualityRelated question
140 people2023
survival worsened with higher cancer stage and poorer tumor grade, and nearly half of patients had the cancer come back
Who was studied
people who developed cancer arising from long-standing pilonidal sinus disease
What they received
having pilonidal sinus disease that progressed to carcinoma
Compared with
different cancer stages and tumor grades compared to each other
Main outcome
survival and cancer recurrence rates
Quality
this is a retrospective pooling of published case reports collected over more than a century, which carries a high risk of bias and selective reporting
Limitations
retrospective literature search spanning 1900-2022, relies on published case reports, follow-up data missing in some cases, and this concerns the rare carcinoma complication rather than pilonidal cysts in general
Taken word for word from the abstract
- n 140 cases of PSD carcinoma were published in 103 papers
- population all reports of carcinoma developing on the background of PSD
- intervention carcinoma developing on the background of PSD
- comparator significant survival difference between stages: 80.0% in stages I and II, 70.8% in stage III, and 47.8% in stage IV
- primaryOutcome The study aims to determine the survival and recurrence rates of pilonidal sinus disease (PSD) carcinoma.
- result Pilonidal sinus carcinoma has a worse prognosis than primary cutaneous squamous cell carcinoma. Poor prognostic factors include advanced-stage disease and poor differentiation.
- result Recurrence occurred in 46.6% of the patients.
J Surg Oncol · PMID 37195200 · Read it on PubMed ↗
Matera et al. 2023
Pilonidal disease of the anterior perineum: an unusual presentation and review of current practice guidelines
Case report, no danger data.Case seriesVery low qualityRelated question
1 people2023
The man had surgery for the gluteal disease and hair removal for the unusual perineal pits; the abstract does not report long-term outcome data
Who was studied
20-year-old man with recurrent pilonidal abscesses, with unusual anterior perineum involvement
What they received
Bascom cleft lift surgery, with hair removal for the anterior perineal pits
Main outcome
Surgical management and resolution of pilonidal disease
Quality
This is a single case report, which cannot show whether the condition is generally dangerous or how treatment affects outcomes.
Limitations
Single case report describing a rare anatomical presentation; no outcome follow-up or safety data on danger of pilonidal cysts in general is given.
Taken word for word from the abstract
- population A 20-year-old man with recurrent pilonidal abscesses of the gluteal cleft underwent a Bascom cleft lift procedure for definitive care of his disease.
- intervention underwent a Bascom cleft lift procedure for definitive care of his disease
- intervention the anterior perineal disease was treated only with removal of hair from within the pits and clipping the hair of the perineum
- primaryOutcome this case highlights the current standard of care and surgical options for pilonidal disease
- result the ideal surgical options for rare cases of pilonidal disease of the anterior perineum remain to be determined
- n A 20-year-old man
Wounds · PMID 37023351 · Read it on PubMed ↗
Horesh et al. 2023
Outcomes of Laser-Assisted Closure (SiLaC) Surgery for Chronic Pilonidal Sinus Disease
High healing rate after laser surgery.Case seriesLow qualityRelated question
92 people2023
81.3% of patients achieved complete healing, with about 10% having recurrence or non-healing disease
Who was studied
adults with chronic pilonidal sinus disease who had minimally invasive laser surgery
What they received
laser-assisted closure (SiLaC) surgery for pilonidal sinus
Compared with
no comparison group; all patients received the same laser procedure
Main outcome
complete healing of the pilonidal sinus
Quality
This was a retrospective, single-arm case series without a comparison group, so it can't show how well the surgery works compared with other options.
Limitations
Retrospective analysis, no control group, single-center experience, and one patient lost to follow-up.
Taken word for word from the abstract
- n A total of 92 patients (86 males, 93.4%) underwent SiLaC surgery for pilonidal sinus disease during the study period.
- population A retrospective analysis of a prospective database of all patients who underwent minimally invasive surgery combined with laser therapy for PNS between September 2018 and December 2020 was performed.
- intervention sinus laser-assisted closure (SiLaC) of pilonidal disease
- comparator A retrospective analysis of a prospective database of all patients who underwent minimally invasive surgery combined with laser therapy for PNS between September 2018 and December 2020 was performed.
- primaryOutcome The primary outcome was complete healing rate, standing at 81.3% (74/91 patients).
- result The primary outcome was complete healing rate, standing at 81.3% (74/91 patients).
J Laparoendosc Adv Surg Tech A · PMID 36888964 · Read it on PubMed ↗
Mahjoubi et al. 2022
RADICAL VERSUS CONSERVATIVE METHODS IN ONE-STAGE PILONIDAL ABSCESS SURGERY: THE EXPERIENCE OF A TUNISIAN CENTER
Excision fewer recurrences, slower healing.RetrospectiveLow qualityRelated question
57 people2022
Excision had lower recurrence but slower wound healing and longer time to return to activity than incision
Who was studied
patients having surgery for a pilonidal abscess
What they received
radical surgery (excision)
Compared with
conservative surgery (incision, curettage, or drainage)
Main outcome
recurrence of the abscess, complications, healing time, and return to activity
Quality
This was a small retrospective study comparing surgical techniques, not addressing the danger of pilonidal cysts directly, so it carries little weight for that question.
Limitations
Retrospective design, small sample size, no randomization, and it studied abscess surgery outcomes rather than the inherent danger of pilonidal cysts.
Taken word for word from the abstract
- population patients operated on for pilonidal abscess
- n We analyzed 57 patients
- intervention The type of operation was excision in 46 (81%) cases
- comparator incision in 11 (19%) cases associated with curettage in three cases and drainage in 1 case
- primaryOutcome We looked for the occurrence of postoperative recurrence
- result Conservative surgery was significantly associated with faster healing of the surgical wound (p<0.001). The recurrence rate was 19% in radical surgery and 54% in conservative surgery.
Arq Bras Cir Dig · PMID 36542008 · Read it on PubMed ↗
Serup et al. 2023
Long-term outcome after Bascom's pit-pick procedure for pilonidal sinus disease: A cohort study
Most patients healed well long-term.RetrospectiveModerate qualityRelated question
158 people7.98 (0.66, 10.96) years
68% treatment success; 10-year cumulative recurrence rate was 27%; more than 90% had no complications or chronic pain; over 70% were satisfied with cosmetic appearance
Who was studied
patients with simple pilonidal sinus disease who had a specific minor surgery called Bascom's pit-pick procedure
What they received
Bascom's pit-pick procedure (a minor surgical technique for pilonidal sinus)
Main outcome
long-term risk of treatment failure, incomplete wound healing, recurrence, complications, pain and cosmetic satisfaction
Quality
it followed a reasonably large group of patients for many years, but there was no comparison group and it relied partly on patient surveys.
Limitations
No comparator group, relies on patient self-report via survey/telephone interview, single-center database, and results apply only to this specific surgical technique rather than to the natural course of untreated pilonidal disease.
Taken word for word from the abstract
- n A total of 158 patients underwent Bascom's pit-pick procedure during the period August 2007 to March 2014.
- population Previous studies have shown favourable short-term results after Bascom's pit-pick procedure for simple pilonidal sinus disease.
- intervention Bascom's pit-pick procedure
- primaryOutcome we aimed to estimate the long-term risk of treatment failure, incomplete wound healing or recurrence, postoperative complications and patient reported outcome measures such as chronic pain and satisfaction with cosmetic appearance
- result Treatment success was 68%.
- result the 10-year cumulative recurrence rate was 27% (95% CI: 19%-35%) of patients with complete wound healing
- result More than 90% had no postoperative complications or chronic pain, and more than 70% reported a high satisfaction with the cosmetic appearance.
- followUp Median follow-up was 7.98 (0.66, 10.96) years.
Colorectal Dis · PMID 36268754 · Read it on PubMed ↗
Cerulo et al. 2022
Minimally invasive pilonidal sinus disease (PSD) treatment in pediatric patients: A narrative review
Can cause infection or abscess.Narrative reviewLow qualityRelated question
size not given2022
Endoscopic approach linked to shorter surgery and recovery, less pain, higher satisfaction, and fewer complications than open surgery, but little pediatric-specific data exists
Who was studied
Children and teenagers with pilonidal sinus disease
What they received
Minimally invasive endoscopic surgery for pilonidal sinus
Compared with
Open surgery for pilonidal sinus
Main outcome
Complications, pain, recovery time and satisfaction after treatment
Quality
This is a narrative review with little data specific to children and no numbers of patients given.
Limitations
Abstract states very poor reports are available in literature about pediatric population, and no study sizes or designs are detailed.
Taken word for word from the abstract
- population very poor reports are available in literature about pediatric population
- intervention minimally invasive approaches have been described
- comparator compared to open surgery
- primaryOutcome Advantages include shorter operative time and time to discharge
- result Published results of studies of newer approaches have demonstrated a lower short and long-term complication rate compared to open surgery.
- limitations very poor reports are available in literature about pediatric population
- plainFinding can lead to complications including infection and abscess formation
Pediatr Med Chir · PMID 35293199 · Read it on PubMed ↗
Yildiz 2022
Partial primary closure in sacrococcygeal pilonidal sinus: Modified with suture technique
Mixed results between two surgery methods.Randomised trialLow qualityRelated question
96 people2022
Hospital stay was shorter with partial closure but not significantly so; healing took longer in uncomplicated cases; infections were more common with partial closure (21.7% vs 10%); but healing time was significantly shorter with partial closure in complicated cases
Who was studied
people with pilonidal sinus disease needing surgery
What they received
partial primary closure technique with suture modification
Compared with
Karydakis flap surgical technique
Main outcome
hospital stay length, wound healing time, and surgical complications
Quality
It is a randomized trial but with a small number of patients and results that varied by outcome, with some differences not reaching statistical significance.
Limitations
Small sample size (96 patients), some key differences were not statistically significant, and the study compares two surgical techniques rather than addressing the danger of the condition itself.
Taken word for word from the abstract
- n A total of 96 patients diagnosed with pilonidal sinus disease (PSD) were randomly assigned to two groups.
- population 96 patients diagnosed with pilonidal sinus disease (PSD) were randomly assigned to two groups
- intervention Apply the partial primary closure in 46 patients
- comparator the Karydakis technique in 50
- primaryOutcome the partial primary closure (PPC) group's hospitalization stay was shorter, although the difference was not significant. Healing time was also longer in uncomplicated cases
- result Surgical site infections were often seen in the PPC group (21.7% vs. 10%). In contrast, healing time for complicated cases was found to be significantly shorter in the PPC technique (p < 0.05).
Asian J Surg · PMID 34303591 · Read it on PubMed ↗
Rudd et al. 2021
Presentation, Management, and Women's Health Implications of Pilonidal Disease
Pilonidal disease impacts quality of life.Narrative reviewVery low qualityRelated question
size not given2021
Obtaining an accurate diagnosis and appropriate care can positively impact quality of life for people with PD
Who was studied
people with pilonidal disease, especially women
What they received
clinical assessment, treatment, therapy, and patient education for pilonidal disease
Main outcome
impact of pilonidal disease on quality of life and accurate diagnosis/care
Quality
This is a narrative review describing the disease and care approach without original data or comparative outcomes.
Limitations
No original data, outcomes, or study design details are reported; the abstract is descriptive and educational rather than evidence-based.
Taken word for word from the abstract
- population Because PD is more common in men than women, it is often misdiagnosed and undertreated in female patients.
- intervention requires clinicians to be vigilant in assessments, treatments, therapies, referrals, and patient education
- result Obtaining an accurate diagnosis and appropriate care can positively impact quality of life for people with PD.
- primaryOutcome Its impact on an individual's life, work, and health, however, cannot be underestimated.
Nurs Womens Health · PMID 34216557 · Read it on PubMed ↗
Zou et al. 2022
Prognostic factors of flap techniques for pilonidal disease based on magnetic resonance imaging and clinical parameters
Surgery risk factors identified, not danger of cyst itself.RetrospectiveLow qualityRelated question
100 people42 (range, 20-90) months
larger sinus diameter and skin thickness linked to early complications; less fat thickness linked to late complications; higher BMI linked to recurrence
Who was studied
patients with pilonidal sinus undergoing flap surgery
What they received
Limberg flap or Karydakis flap surgery
Compared with
different MRI-measured anatomical parameters and patient factors
Main outcome
postoperative complications and recurrence
Quality
This was a retrospective study looking back at records, which can't prove cause and effect.
Limitations
Retrospective design; focuses on surgical complication risk factors rather than whether the cyst itself is dangerous.
Taken word for word from the abstract
- population 100 patients receiving Limberg flap (LF) or Karydakis flap (KF) surgery
- intervention Limberg flap (LF) or Karydakis flap (KF) surgery
- comparator a multivariate logistic analysis on the clinicopathological parameters and MRI data to identify risk factors for complications and recurrence
- primaryOutcome Postoperative complications and recurrence are major diffficulties in the flap techniques
- result a large longitudinal sinus diameter (OR = 1.020, 95%CI = 1.000-1.041) and sacrococcygeal dermal thickness (OR = 1.680, 95%CI = 1.142-2.472) to be independent risk factors for early complications
- n A total of 100 patients receiving Limberg flap (LF) or Karydakis flap (KF) surgery
Asian J Surg · PMID 34158202 · Read it on PubMed ↗
Driouch et al. 2022
[Results of the Limberg flap procedure in acute and chronic pilonidal abscesses]
Surgery outcomes similar for abscess, sinus.Prospective cohortLow qualityRelated question
39 people2022
similar wound healing issues in both groups (10% vs 17%) and no recurrences in the acute abscess group vs 11% in the chronic sinus group, neither difference statistically significant
Who was studied
patients with acute pilonidal abscess or chronic pilonidal sinus
What they received
one-stage surgery with Limberg flap for acute pilonidal abscess
Compared with
one-stage surgery with Limberg flap for chronic pilonidal sinus
Main outcome
wound healing problems and recurrence after surgery
Quality
small, non-randomized observational study with only 39 patients and no significant differences found.
Limitations
Small sample size, non-randomized observational design, no significant statistical differences found, single surgical technique only.
Taken word for word from the abstract
- n a total of 39 patients were included in this prospective observational study
- population 21 patients with acute pilonidal abscess and 18 patients with chronic pilonidal sinus
- intervention a 1‑stage procedure using the Limberg flap method
- comparator chronic pilonidal sinus
- primaryOutcome compare the results of the 1‑stage surgery with plastic reconstruction according to Limberg for acute pilonidal abscess and chronic pilonidal sinus in terms of recurrence, disorders of wound healing, inpatient length of stay and patient satisfaction
- result a comparable rate of postoperative wound healing disorders (10% vs. 17%, p = 0.647)
- result there was no recurrence during the observational period, while in the chronic pilonidal sinus group there were 2 (11%) recurrences (p = 0.206)
Chirurg · PMID 34132822 · Read it on PubMed ↗
Khalilieh et al. 2022
Surgical Outcomes of Minimally Invasive Trephine Surgery for Pilonidal Sinus Disease and Risk Factors for Recurrence
High recurrence, but repeat surgery works wellProspective cohortLow qualityRelated question
130 people2022
About one third had recurrence or a wound that didn't heal; repeat surgery was successful in most who had it
Who was studied
patients with pilonidal sinus disease having minimally invasive surgery
What they received
minimally invasive Trephine surgery to remove pilonidal sinus
Compared with
none (single group followed over time, risk factors analyzed)
Main outcome
rate of disease recurrence or non-healing wound after surgery
Quality
It is a single-arm study with no comparison group and data were only available for 64% of patients, so recurrence rates may be biased.
Limitations
Only 64.2% of patients had data available; no control group; retrospective telephone survey used to assess recurrence
Taken word for word from the abstract
- population patients who underwent PNS Excision by Trephine MIS Procedure
- intervention MIS Trephine procedure for PNS
- comparator A prospective cohort, including patients who underwent PNS Excision by Trephine MIS Procedure over 5 years
- primaryOutcome Overall recurrence and nonhealing wound rate was 33.07% (43 patients)
- result Overall recurrence and nonhealing wound rate was 33.07% (43 patients), with disease recurrence occurring in mean time of 13.3 months (range 2-47 months).
- result Overall healing rate following repeat surgery was 91.5% (119 patients).
- n Two hundred three patients underwent MIS Trephine procedure for PNS, with data available on 130 patients (64.2%).
J Laparoendosc Adv Surg Tech A · PMID 33960849 · Read it on PubMed ↗
Iesalnieks et al. 2021
German National Guideline on the management of pilonidal disease: update 2020
Asymptomatic cysts don't need treatment.GuidelineModerate qualityRelated question
size not given2021
treatment should match disease type; no single method is painless, fast-healing, and low-recurrence; asymptomatic disease needs no treatment, abscesses need drainage, and chronic disease is treated with excision or flap procedures with trade-offs
Who was studied
people with pilonidal cyst disease
What they received
various surgical treatments for pilonidal disease
Compared with
different surgical techniques compared to each other
Main outcome
wound healing, recurrence rate, and time off work
Quality
This is an expert guideline based on a literature review rather than a single controlled trial, so it summarizes evidence but doesn't test one treatment directly.
Limitations
No single treatment method meets all desired criteria; guideline is based on systematic literature review rather than new trial data; does not directly address danger/risk of untreated disease.
Taken word for word from the abstract
- result Asymptomatic pilonidal disease should not be treated. A pilonidal abscess should be unroofed.
- population Three types of disease manifestation could be differentiated: asymptomatic disease, an acute abscess, and the chronic pilonidal disease.
- intervention sinus excision is the standard treatment of the chronic pilonidal disease
- comparator The Limberg flap and the Karydakis procedure are two best described methods which are associated with similar short- and long-term results.
- primaryOutcome simple, painless procedure associated with rapid wound healing, and low recurrence rate
Langenbecks Arch Surg · PMID 33950407 · Read it on PubMed ↗
Mantoğlu et al. 2021
Cause of an acute abdomen never seen: Intraabdominal perforation of an umbilical pilonidal sinus abscess
Rare case of dangerous abdominal rupture.Case seriesVery low qualityRelated question
size not given2021
has caused acute abdomen
Who was studied
a person with umbilical pilonidal sinus who had never had symptoms before
What they received
no treatment (untreated umbilical pilonidal sinus)
Compared with
none
Main outcome
development of acute abdomen
Quality
this is a single case report, so it cannot show how common or likely this outcome is.
Limitations
Single case report of umbilical (not sacrococcygeal) pilonidal sinus; no control group; case-based evidence only.
Taken word for word from the abstract
- population our case which has never had symptoms before and has caused acute abdomen
- intervention The umbilical pilonidal sinus, which is not treated medically or surgically
- primaryOutcome may cause regional or generalized infections
- result has caused acute abdomen
- comparator Treatment is based on clinical experience rather than on evidence-based medicine.
Ulus Travma Acil Cerrahi Derg · PMID 33630288 · Read it on PubMed ↗
Manigrasso et al. 2021
Early versus delayed endoscopic treatment of acute pilonidal abscess: a propensity score-matched analysis
Similar recurrence, earlier treatment felt betterRetrospectiveLow qualityRelated question
82 people5-year
no difference in recurrence between early and delayed treatment, but early treatment had better patient satisfaction and health status
Who was studied
patients with an acute pilonidal abscess
What they received
early video-assisted ablation of pilonidal sinus (VAAPS) performed immediately
Compared with
delayed VAAPS performed after incision and drainage
Main outcome
recurrence rate at 1, 3, and 5 years
Quality
This is a retrospective, propensity-matched study with a small number of patients, so it can't prove the treatments are truly equal or better.
Limitations
Retrospective design with propensity score matching rather than randomization; small sample size
Taken word for word from the abstract
- population All consecutive patients with an acute pilonidal abscess
- intervention early VAAPS group
- comparator delayed VAAPS group
- primaryOutcome Primary outcomes were recurrence rate at 1-year, 3-year, and 5-year follow-up.
- result No differences were found in terms of recurrence in the two groups. Early endoscopic approach was associated with a better patients' satisfaction (8.17 ± 1.2 vs 6.06 ± 1.48, p = 0.001) and a better postoperative health status (86.27 ± 6.54 vs 77.32 ± 5.85, p = 0.001).
- n 82 patients were included in the final analysis (41 in each group)
Int J Colorectal Dis · PMID 33011845 · Read it on PubMed ↗
Ferhatoglu et al. 2019
Effects of Bathing Habits on Postoperative Wound Complications Following Sacrococcygeal Pilonidal Sinus Surgery: A Retrospective Analysis of 67 Adolescent Patients
Frequent bathing raised infection risk.RetrospectiveLow qualityRelated question
67 people90 days
patients who bathed more than twice a week in the first 28 days after surgery had higher rates of wound infection; no difference in complications between 28 and 90 days
Who was studied
adolescent patients who had surgery for sacrococcygeal pilonidal sinus disease
What they received
bathing more than twice per week after surgery
Compared with
bathing twice per week or less after surgery
Main outcome
postoperative wound infection and wound separation
Quality
it is a small, single-center retrospective chart review without randomization, so bathing habits could be linked to other unmeasured factors.
Limitations
Retrospective design, single center, no randomization, and the study looks at postoperative bathing habits rather than the underlying danger of the cyst itself.
Taken word for word from the abstract
- n 67 patients were evaluated for demographics
- population 79 adolescent patients who underwent sacrococcygeal pilonidal sinus surgery
- intervention Wound infection rates were found to be higher in patients who bathed more than twice weekly during the 28 days after surgery
- comparator No statistical significance was observed in complication rates from days 28 to 90 after the surgery between those who bathed twice weekly and more than twice weekly
- primaryOutcome postoperative wound infection and dehiscence
- result Wound infection rates were found to be higher in patients who bathed more than twice weekly during the 28 days after surgery (P = .005).
Wounds · PMID 31747369 · Read it on PubMed ↗
Demiryas et al. 2019
Could Early Postoperative Complications be Considered as Risk Factor for Recurrence after Pilonidal Sinus Surgery?
Wound problems raise recurrence risk.RetrospectiveLow qualityRelated question
841 people48.6 21.4 months in KP group and 48.2 +- 21.7 months in MLF group
Recurrence rate was 6% with Karydakis and 4.72% with modified Limberg flap, and wound dehiscence or infection were risk factors for recurrence in both groups
Who was studied
patients with sacrococcygeal pilonidal disease who had surgery
What they received
Karydakis procedure for pilonidal sinus
Compared with
modified Limberg flap procedure for pilonidal sinus
Main outcome
recurrence and early postoperative complications after surgery
Quality
This is a retrospective study comparing two surgical techniques without randomization, so it mainly shows associations with complications and recurrence rather than how dangerous the underlying cyst itself is.
Limitations
Retrospective design, single-surgeon approach, and no random assignment between surgical groups.
Taken word for word from the abstract
- n Eight hundred forty-one patients were evaluated in this work.
- population patients undergoing surgical treatment for PD
- intervention KP (n=417)
- comparator MLF (n=424)
- primaryOutcome We aimed to determine risk factors for possible complications and especially recurrence in the patients undergoing surgical treatment for PD.
- result The rate of recurrence ratio was determined to be 6% in the KP and 4.72% in the MLF groups. In both of the groups, dehiscence or WI was found to be risk factors for recurrence.
- followUp the follow-up period of patients was 48.6 21.4 months in KP group and 48.2 +- 21.7 months in MLF group
Chirurgia (Bucur) · PMID 31511134 · Read it on PubMed ↗
Konrad Wroński 2019
A rare case of squamous cell carcinoma arising from chronic sacrococcygeal pilonidal disease
Rare cancer from long-term cyst.Case seriesVery low quality
1 people2019
One patient developed squamous cell carcinoma from long-standing pilonidal disease
Who was studied
Patient with long-term sacrococcygeal pilonidal cyst disease
What they received
No treatment tested; case description of cancer arising from chronic pilonidal disease
Main outcome
Development of squamous cell skin cancer from chronic pilonidal cyst
Quality
This is a single case report, so it cannot show how often this happens or to whom.
Limitations
Single case report with no control group or data on how common this is beyond a cited rate.
Taken word for word from the abstract
- n This article presents the case of a patient with diagnosed squamous cell carcinoma arising from chronic sacrococcygeal pilonidal disease.
- population Pilonidal disease is a chronic disorder which is observed in boys and men between ages of 15 and 40 years old in Caucasian race.
- intervention This article presents the case of a patient with diagnosed squamous cell carcinoma arising from chronic sacrococcygeal pilonidal disease.
- primaryOutcome Malignant degeneration and carcinoma arising from chronic sacrococcygeal pilonidal disease are observed extremely rare and are described in the group of Marjolin cancer.
- result The incidence of carcinoma arising in pilonidal disease is less than 0,1% and in the whole medical journals less than 100 patients are reported.
Ann Ital Chir · PMID 31293248 · Read it on PubMed ↗
Khafagy et al. 2019
The endoscopic treatment of pilonidal sinus disease: a short-term case-series study
Good short-term healing, some recurrence.Case seriesLow qualityRelated question
35 people6 months
most patients had minimal pain and no serious wound complications, but 6% had the condition come back within 6 months
Who was studied
patients with long-term or recurring pilonidal sinus disease
What they received
endoscopic pilonidal sinus treatment (EPSiT) procedure
Compared with
none (no comparison group)
Main outcome
pain control, wound complications, and recurrence rate
Quality
this is a small single-group study with only 35 patients and just 6 months of follow-up, so it cannot say how dangerous the disease is or compare treatments reliably
Limitations
Short follow-up period with a small number of patients
Taken word for word from the abstract
- n SAMPLE SIZE: 35 patients.
- population patients with symptomatic chronic or recurrent PNS
- intervention endoscopic pilonidal sinus treatment (EPSiT) procedure
- comparator Case series.
- primaryOutcome Control of pain, wound complications, recurrence rate over a 6-month follow up.
- result No patient experienced early wound complications necessitating hospitalization. There were 2 (6%) recurrences encountered by the time of the 6-month follow-up period.
- limitations Short follow-up period with a small number of patients
- followUp 6-month follow-up period
Ann Saudi Med · PMID 31215233 · Read it on PubMed ↗
Keighley et al. 2019
Pilonidal abscess of the breast
Caused recurring abscess needing surgeryCase seriesVery low qualityRelated question
1 people2019
the abscess recurred despite antibiotic therapy and needle aspiration, and surgery was needed; histology showed it was a pilonidal abscess
Who was studied
a 52-year-old woman who presented via the breast clinic complaining of nipple inversion and pain
What they received
surgical excision of the abscess cavity after antibiotics and needle aspiration failed
Compared with
earlier antibiotic therapy and needle aspiration
Main outcome
whether the breast abscess resolved and what caused it
Quality
This is a single patient's case report, so it cannot show how often this happens or how dangerous it generally is.
Limitations
Single case report of an unusual body site (breast) rather than the typical natal cleft location, so it may not generalise to typical pilonidal cysts.
Taken word for word from the abstract
- population a case of periareolar pilonidal abscess in the breast of a 52-year-old woman who presented via the breast clinic complaining of nipple inversion and pain
- intervention the patient therefore underwent surgical excision of the abscess cavity
- comparator recurred despite antibiotic therapy and needle aspiration
- primaryOutcome Clinical examination and imaging revealed an underlying abscess which recurred despite antibiotic therapy and needle aspiration
- result Subsequent histology diagnosed pilonidal abscess, an important differential to consider in the case of breast abscess, particularly in cases that are slow to resolve or recur post-treatment.
- n a 52-year-old woman
BMJ Case Rep · PMID 30936332 · Read it on PubMed ↗
Delvecchio et al. 2019
Squamous carcinoma in pilonidalis sinus: case report and review of literature
Can rarely turn cancerous.Case seriesVery low quality
1 people5 years
the chronic pilonidal sinus had turned into squamous cell carcinoma, occurring in about 0.1% of pilonidal sinus cases after 20-30 years of chronic abscess
Who was studied
an 83-year-old patient with a recurrence of pilonidal sinus after 30 years
What they received
surgical excision of the pilonidal sinus mass plus adjuvant radiotherapy
Main outcome
whether cancer can develop from a long-standing pilonidal sinus
Quality
this is a single patient case report combined with a literature review, so it cannot show how common this risk really is.
Limitations
only one case is described and all other literature cited is also case reports, with no controlled data on actual risk.
Taken word for word from the abstract
- n Patient of 83 years old, that after 30 years had a recurrence of pilonidal sinus revealed by a sacral abscess
- population Patient of 83 years old, that after 30 years had a recurrence of pilonidal sinus revealed by a sacral abscess
- intervention a second surgical look with mass excision until the presacral fascia and V-Y flap was performed
- intervention the patient underwent adjuvant radiotherapy cycles
- primaryOutcome We report a case of squamous carcinoma arising from a pilonidal sinus.
- result The incidence of carcinoma arising from a pilonidalis sinus is about 0.1% and the most important risk factor is represented by a chronic abscess from 20-30 years.
G Chir · PMID 30771803 · Read it on PubMed ↗
Meinero et al. 2019
Endoscopic pilonidal sinus treatment (EPSiT) in recurrent pilonidal disease: a prospective international multicenter study
High healing rate after surgeryProspective cohortLow qualityRelated question
122 people2019
95% of patients healed completely, average healing time 29 days, recurrence in 5.1% of cases, and quality of life improved by 30 days
Who was studied
patients with pilonidal disease that came back after previous surgery
What they received
endoscopic pilonidal sinus treatment (EPSiT), a minimally invasive surgery
Compared with
no control group used; abstract only compares narratively to other unspecified techniques
Main outcome
wound healing rate and time, complications, recurrence, and quality of life
Quality
this was a single-arm study with no comparison group, so it cannot show whether the disease itself is dangerous or how this treatment compares to others.
Limitations
No control/comparator group; abstract does not describe complication rates of untreated disease or dangerousness of the cyst itself.
Taken word for word from the abstract
- population Of the consecutive prospective patients with recurrent PD, 122 were enrolled
- intervention endoscopic pilonidal sinus treatment (EPSiT)
- comparator It enables excellent short- and long-term outcomes than various other techniques that are more invasive.
- primaryOutcome Primary endpoint was to evaluate short- and long-term outcomes: healing rate/time, morbidity rate, re-recurrence rate, and patient's quality of life (QoL).
- result Complete wound healing rate was occurred in 95% of the patient, with a mean complete wound healing time of 29 ± 12 days.
- result recurrence was reported in six cases (5.1%)
- n 122 were enrolled in a prospective international multicenter study
Int J Colorectal Dis · PMID 30719564 · Read it on PubMed ↗
Hardy et al. 2019
Fibrin glue obliteration is safe, effective and minimally invasive as first line treatment for pilonidal sinus disease in children
Glue treatment safe, low recurrenceCase seriesLow qualityRelated question
18 people52 weeks (17-102)
Most needed only one procedure, one recurrence (5.6%), and two minor wound infections occurred
Who was studied
children and teenagers with pilonidal sinus disease
What they received
fibrin glue obliteration of the pilonidal sinus
Compared with
none (single-group review, with one patient eventually having formal excision)
Main outcome
recurrence and complications after treatment
Quality
This is a small single-surgeon case series of 18 patients with no comparison group, so it cannot reliably show how risky the underlying cyst is.
Limitations
Small sample size, single surgeon, no control group, and level IV evidence as stated by the authors.
Taken word for word from the abstract
- n Eighteen patients were identified.
- population Review of all pediatric patients receiving FGO of pilonidal sinus
- intervention Fibrin glue obliteration (FGO)
- comparator 1 elected for formal excision after 2 FGO treatments.
- primaryOutcome Median follow-up was 52 weeks (17-102), during which time there was 1 recurrence (5.6%).
- result Two patients developed minor surgical site infections.
- result Median follow-up was 52 weeks (17-102), during which time there was 1 recurrence (5.6%).
- followUp Median follow-up was 52 weeks (17-102)
J Pediatr Surg · PMID 30268489 · Read it on PubMed ↗
Burney 2018
Treatment of pilonidal disease by minimal surgical excision under local anesthesia with healing by secondary intention: Results in over 500 patients
Minor surgery, low recurrence rate.Case seriesLow qualityRelated question
570 peoplemean follow-up was 4.7 years
3.2% of patients needed reoperation for persistent or recurrent disease; most healed afterward, with low overall morbidity
Who was studied
patients with pilonidal disease treated surgically
What they received
minimal surgical excision under local anesthesia with wound healing by secondary intention
Main outcome
wound healing time and rate of persistent or recurrent disease needing reoperation
Quality
This is a single surgeon's retrospective review of his own patients with no comparison group, so it mainly shows this doctor's own results rather than proof the approach is better than other options.
Limitations
Single-surgeon retrospective case series without a control group or randomization; relies on chart review and patient compliance.
Taken word for word from the abstract
- population Records of all patients I treated for pilonidal disease from 1978 to 2015 with at least 1 year of follow-up were reviewed.
- intervention minimal but complete surgical excision under local anesthesia with healing by secondary intention using moist dressings
- n Records were found for 570 patients
- primaryOutcome length of time until wound healed
- primaryOutcome Eighteen patients (3.2%) had persistent or recurrent disease requiring reoperation
- result Eighteen patients (3.2%) had persistent or recurrent disease requiring reoperation, most often because of poor compliance with wound care instructions, and later healed.
- followUp mean follow-up was 4.7 years
Surgery · PMID 30064734 · Read it on PubMed ↗
Tien et al. 2018
Outcomes of endoscopic pilonidal sinus treatment (EPSiT): a systematic review
Good healing with minimally invasive surgery.Systematic reviewLow qualityRelated question
size not given2018
good complete healing rates, low recurrence, high satisfaction and little time off work
Who was studied
people with pilonidal sinus disease
What they received
endoscopic pilonidal sinus treatment (EPSiT)
Compared with
no consistent comparator reported across studies
Main outcome
healing, recurrence, patient satisfaction and time off work
Quality
Most included studies were small case series without comparison groups, so the findings are not strongly reliable.
Limitations
The main limitation was the lack of comparative studies.
Taken word for word from the abstract
- population Pilonidal sinus is a common disease of the natal cleft
- intervention endoscopic pilonidal sinus treatment (EPSiT)
- comparator The main limitation was the lack of comparative studies.
- primaryOutcome These studies demonstrated that EPSiT has good complete healing rates and low recurrence rates.
- result These studies demonstrated that EPSiT has good complete healing rates and low recurrence rates. There was also a high level of patient satisfaction and little time taken off work.
- limitations The main limitation was the lack of comparative studies.
Tech Coloproctol · PMID 29850944 · Read it on PubMed ↗
Milone et al. 2018
Long-term follow-up for pilonidal sinus surgery: A review of literature with metanalysis
High chance disease returns after surgery.Meta-analysisModerate qualityRelated question
size not givenminimum follow-up of 5 years
overall recurrence was 13.8%, with recurrence rates of 17.9% for open healing, 16.8% for midline closure, and 10% for off-midline closure
Who was studied
people who had surgery for pilonidal sinus disease
What they received
different surgical techniques for closing the wound (open healing, midline closure, off-midline closure)
Compared with
the surgical techniques compared against each other
Main outcome
rate of the disease coming back (recurrence) after surgery, over long-term follow-up
Quality
it pools many studies with long follow-up, but the studies used different surgical methods and reporting, so the combined numbers are rougher estimates.
Limitations
The abstract does not address whether pilonidal cysts themselves are dangerous (e.g. infection spread, complications); it only reports recurrence rates after different surgeries, and patient numbers per study varied widely.
Taken word for word from the abstract
- population all studies reporting a surgical approach to PSD with a minimum follow-up of 5 years
- intervention open healing, midline closure and out-midline closure
- comparator an analysis of recurrence rate of various surgical techniques in a long-term follow-up
- primaryOutcome The overall incidence of recurrence was of 0.138
- result the resulting incidence of open healing, midline closure and out-midline closure were of 17.9%, 16.8% and 10% respectively
- followUp a minimum follow-up of 5 years
Surgeon · PMID 29699781 · Read it on PubMed ↗
Ercil et al. 2018
Recurrent Pilonidal Sinus Cyst on Penis
Rare recurrent cyst, no danger shown.Case seriesVery low qualityRelated question
1 people2018
a recurrent pilonidal sinus on the penis was found to be linked to a bacterial infection (Actinomyces israelii)
Who was studied
20-year-old man with a recurring sore on the penis
What they received
no treatment described (case report)
Compared with
none
Main outcome
description of the penile lesion and its cause
Quality
this is a single patient case report, so it cannot show how common or dangerous this condition is in general.
Limitations
only one patient; no comparison group; rare and unusual presentation
Taken word for word from the abstract
- n A 20-year-old male presented to the urology outpatient clinic
- population A 20-year-old male presented to the urology outpatient clinic with the complaint of a suppurative lesion with discharge on the skin of the penis
- intervention We present the first case in literature of recurrent pilonidal sinus related to Actinomyces israelii, located on the penis.
- primaryOutcome Clinical examination revealed an indurated, erythematous, ulcerative lesion, 3 cm x 2 cm in size, in the middle of the ventral aspect of the penile shaft.
- result We present the first case in literature of recurrent pilonidal sinus related to Actinomyces israelii, located on the penis.
- comparator We present the first case in literature of recurrent pilonidal sinus related to Actinomyces israelii, located on the penis.
Arch Iran Med · PMID 29688739 · Read it on PubMed ↗
Eberspacher et al. 2017
Pilonidal disease mimicking anterior anal fistula and associated with posterior anal fistula: a two-step surgery. Case report
Rare complicated case, treated successfully.Case seriesVery low qualityRelated question
1 peopleabout one month
The posterior anal fistula healed well and the residual pilonidal sinus was excised successfully
Who was studied
A 36-year old man with an anal fistula
What they received
Two-step surgery: fistulectomy, abscess drainage, seton placement, then excision of pilonidal sinus
Main outcome
Healing of the fistula and pilonidal disease without complications or recurrence
Quality
This is a single case report, which cannot show how often problems happen or how risky the condition generally is.
Limitations
Single case report with no comparison group; findings may not generalize to other patients with pilonidal disease.
Taken word for word from the abstract
- population A 36-year old man was referred to our department with an anal fistula with an anterior opening.
- intervention We performed a two-step surgery with a first fistulectomy of the anterior tract, a drainage of abscess and the positioning of a seton for the posterior fistula.
- primaryOutcome we evaluate the good healing of posterior anal fistula and excised the residual pilonidal sinus
- result After about one month and the fall of the seton we evaluate the good healing of posterior anal fistula and excised the residual pilonidal sinus.
- n A 36-year old man
G Chir · PMID 29442064 · Read it on PubMed ↗
Esposito et al. 2018
Pediatric Endoscopic Pilonidal Sinus Treatment, a Revolutionary Technique to Adopt in Children with Pilonidal Sinus Fistulas: Our Preliminary Experience
Healed well, no recurrence, less pain.RetrospectiveVery low qualityRelated question
15 people6 month
all patients healed by 1 month with no recurrence at 6 months, less pain and shorter hospital stay than open surgery
Who was studied
children and teens with pilonidal sinus disease that was not infected
What they received
endoscopic pilonidal sinus surgery (PEPSiT)
Compared with
classic open surgical repair
Main outcome
healing of the sinus, recurrence, pain, and hospital stay
Quality
this is a small, retrospective case series of only 15 patients without randomization, so it cannot reliably prove the new technique is better.
Limitations
retrospective review, small sample size, no randomization, short follow-up of 6 months
Taken word for word from the abstract
- n 15 patients, 6 girls and 9 boys
- population with noninfected pilonidal sinus disease who underwent PEPSiT in our institution
- intervention pediatric endoscopic pilonidal sinus treatment (PEPSiT)
- comparator a comparison analysis with classic open repair was performed
- primaryOutcome Surgical outcomes of sinus healing, recurrence of disease, postoperative pain, hospital stay, analgesic requirements, and patient satisfaction levels were evaluated
- result At 1 month postoperatively, the external openings were closed in all patients and no recurrence was recorded at a mean follow-up of 6 month. PEPSiT was associated with a significantly shorter, painless, and better outcome compared to open technique.
- followUp a mean follow-up of 6 month
J Laparoendosc Adv Surg Tech A · PMID 29232530 · Read it on PubMed ↗
Koutserimpas et al. 2017
Epidural abscess imitating recurrent pilonidal sinus: a case report
Rare serious spinal infection after surgery.Case seriesVery low qualityRelated question
1 peoplea whole year
after surgery for pilonidal sinus, the patient developed an epidural abscess extending from the thoracic spine to the tailbone area, requiring further surgery and antibiotics, and recovered without recurrence after a year
Who was studied
33-year-old man with previously untreated diabetes who had pilonidal sinus surgery
What they received
no intervention being tested; this is a case report of complications after pilonidal cyst surgery
Main outcome
development of a serious spinal infection (epidural abscess) after pilonidal cyst treatment
Quality
this is a single patient case report, so it cannot show how often this happens or whether it applies to others.
Limitations
single case report with undiagnosed diabetes as a likely contributing factor; cannot establish how common or predictable this complication is
Taken word for word from the abstract
- n A 33-year old male
- population A 33-year old male, suffering from previously undiagnosed and untreated diabetes mellitus (DM), presented to our emergency department (ER), one month after open surgical treatment of pilonidal sinus
- intervention We present the first case of an epidural abscess imitating pilonidal sinus.
- primaryOutcome a computer tomogr aphy (CT )scan was performed revealing an epidural abscess extending from the thoracic vertebrae 12 (T-12) to the sacrococcygeal area
- result At that point he underwent new surgery for drainage of the epidural abscess. The patient received intravenous antimicrobial treatment and was discharged on the 23rd postoperative day without signs or symptoms of infection.
- followUp At follow up for a whole year no signs of recurrence have been observed.
G Chir · PMID 29205143 · Read it on PubMed ↗
Danne et al. 2017
A Retrospective Study of Pilonidal Sinus Healing by Secondary Intention Using Negative Pressure Wound Therapy Versus Alginate or Gauze Dressings
No clear healing advantage found.RetrospectiveLow qualityRelated question
73 people2017
no significant difference in healing time or recurrence rate between NPWT and dressing changes
Who was studied
patients with symptomatic natal cleft PS over a 10-year period
What they received
negative pressure wound therapy (NPWT) to achieve wound healing
Compared with
alginate-based/gauze daily dressing changes
Main outcome
time in weeks to achieving the endpoint (epithelialization)
Quality
This was a small retrospective chart review without randomization, so it can't reliably prove whether one wound treatment is better than the other.
Limitations
Retrospective design, small sample size, no randomization, and the authors state prospective randomized controlled studies are needed.
Taken word for word from the abstract
- n 73 consecutive patients who had symptomatic natal cleft PS over a 10-year period
- population 73 consecutive patients who had symptomatic natal cleft PS over a 10-year period
- intervention A retrospective analysis was conducted of data extracted from the medical records of 73 consecutive patients who had symptomatic natal cleft PS over a 10-year period to compare use of NPWT to alginate-based/gauze daily dressing (DD) changes in terms of healing time and recurrence.
- comparator alginate-based/gauze daily dressing (DD) changes
- primaryOutcome time in weeks to achieving the endpoint (epithelialization)
- result The median time to healing was 10 weeks (95% CI: 7-17) in the DD group and 8 weeks (95% CI: 7-9) in the NPWT group (not significantly different).
- result The PS wound recurred in 5 patients - 4 (12.5%) in the DD group and 1 (3.1%) in the NPWT group (P = .355).
Ostomy Wound Manage · PMID 28355137 · Read it on PubMed ↗
Michalopoulos et al. 2017
Squamous cell carcinoma arising from chronic sacrococcygeal pilonidal disease: a case report
Rare case: cancer and death.Case seriesVery low quality
1 people9 months
patient developed squamous cell carcinoma from the chronic pilonidal disease, which despite aggressive surgery and radiation came back and spread, and the patient died 9 months later
Who was studied
60-year-old patient with long-standing pilonidal sinus and an anal fistula
What they received
no intervention being tested; describes surgical and radiation treatment of cancer that developed
Compared with
none
Main outcome
development of skin cancer (squamous cell carcinoma) from chronic pilonidal disease and survival after treatment
Quality
this is a single patient case report, so it cannot show how often this happens or to whom, only that it can happen.
Limitations
Single case report; no comparison group; cannot estimate how common this complication is.
Taken word for word from the abstract
- n a 60-year-old patient with a chronic pilonidal sinus complicated by an anal fistula
- population a 60-year-old patient with a chronic pilonidal sinus complicated by an anal fistula
- intervention the patient was treated with adjuvant radiation therapy postoperatively
- comparator CASE PRESENTATION
- primaryOutcome Rarely, chronic inflammation and recurrent disease leads to malignant transformation, most commonly to squamous cell carcinoma (SCC).
- result Nine months later, recurrence was found in the sacrum and para-aorta lymph nodes and the patient died shortly after.
World J Surg Oncol · PMID 28302173 · Read it on PubMed ↗
Zagory et al. 2016
Excision and Primary Closure May Be the Better Option in the Surgical Management of Pilonidal Disease in the Pediatric Population
Primary closure had fewer recurrences.RetrospectiveLow qualityRelated question
60 people2016
primary closure had the lowest recurrence rate (33.3%) compared with leaving the wound open (58.8%) or flap closure (42.9%), and the shortest hospital stay
Who was studied
young patients (21 years old and younger) who had surgery for pilonidal disease
What they received
excision of the cyst with primary closure of the wound
Compared with
excision with the wound left open to heal on its own, or excision with a skin flap closure
Main outcome
rate of disease coming back after surgery, complications, and length of hospital stay
Quality
This is a retrospective review from one hospital without random assignment to treatment groups, so it cannot reliably prove one surgery is better than another.
Limitations
Retrospective design, single institution, not randomized, and the abstract does not address whether pilonidal cysts themselves are dangerous.
Taken word for word from the abstract
- n Sixty patients (41.7% male) were included in the analysis
- population patients 21 years old and younger who underwent surgical management for pilonidal disease
- intervention 36 (60%) had primary closure
- comparator 17 (28.3%) were left to heal by secondary intention, and 7 (11.7%) had flap closure
- primaryOutcome Overall recurrence rate was 41.7 per cent with 33.3 per cent in the primary, 58.8 per cent in the secondary, and 42.9 per cent in the flap group, respectively.
- result Primary closure had the shortest length of stay (analysis of variance P = 0.04), and flap closure had no reoperations (analysis of variance P < 0.01).
Am Surg · PMID 27779984 · Read it on PubMed ↗
Karadağ et al. 2016
Lateral Orbital Wall Destruction Due to Pilonidal Sinus
Rare case caused bone damage.Case seriesVery low qualityRelated question
size not given2016
The sinus was misdiagnosed and incompletely removed, leading to destruction of the bone in the lateral orbital wall
Who was studied
a patient with a pilonidal sinus in an unusual location near the eye (lateral orbital region)
What they received
incomplete surgical excision of the sinus tract
Compared with
none
Main outcome
damage to the bone around the eye socket
Quality
This is a single case report, so it cannot show how often this happens or what causes it.
Limitations
Single case report with an atypical location of the sinus; misdiagnosis and incomplete treatment contributed to the outcome, which may not reflect typical pilonidal sinus cases.
Taken word for word from the abstract
- population The authors report a patient of a pilonidal sinus in a rare location-the lateral orbital region.
- intervention the subsequent incomplete excision of the sinus tract
- comparator led a pilonidal sinus with a high morbidity resulting in the destruction of bone tissue in the lateral orbital wall
- primaryOutcome resulting in the destruction of bone tissue in the lateral orbital wall
- result The authors' patient was misdiagnosed with an epidermal cyst, and the subsequent incomplete excision of the sinus tract led a pilonidal sinus with a high morbidity resulting in the destruction of bone tissue in the lateral orbital wall.
J Craniofac Surg · PMID 27391513 · Read it on PubMed ↗
Ergözen et al. 2016
Home-applied IPL epilation may prevent the problems due to hair follicle in amputees
Untested idea, no evidence yet.Narrative reviewVery low qualityRelated question
size not given2016
no actual results reported; this is a proposed idea, not a tested treatment
Who was studied
people who have had limb amputation
What they received
home-use intense pulsed light (IPL) hair removal device
Compared with
no comparator described
Main outcome
prevention of skin problems like folliculitis and pilonidal sinus on the stump
Quality
this is just a theoretical proposal with no patients treated or data collected, so it carries almost no weight on its own.
Limitations
the abstract presents an untested hypothesis with no study, data, or outcomes measured
Taken word for word from the abstract
- population Amputees may suffer from dermatoses such as folliculitis and pilonidal sinus caused by pressure on the stump in hairy parts of the skin.
- intervention intense pulsed light technology, which is produced for home epilation
- comparator The use of this kind of epilator in the early period post-amputation may prevent the development of folliculitis and pilonidal sinus.
- primaryOutcome may prevent the development of folliculitis and pilonidal sinus
- result We believe these conditions may be easily, effectively and cheaply prevented with the use of intense pulsed light technology
Med Hypotheses · PMID 27372856 · Read it on PubMed ↗
Korenkov 2016
Subcutaneous Destruction of Sinus Tract with Long-term Vessel Loop Drainage as a Minimally Invasive Surgical Treatment for Primary Pilonidal Sinus
New minimally invasive surgery healed well.Case seriesVery low qualityRelated question
5 people6 weeks
No adverse events occurred such as abscess or recurrent pilonidal sinus; complete wound healing occurred by day 21-28, though one patient had persistent coccygeal pain beyond 6 weeks
Who was studied
patients with primary symptomatic pilonidal sinus
What they received
narrow excision of pilonidal orifices with subcutaneous destruction of the sinus tract plus long-term vessel loop drainage
Compared with
none (single-arm pilot study)
Main outcome
wound healing and occurrence of adverse events such as abscess or recurrence
Quality
This is a tiny pilot case series of only 5 patients with no comparison group, so it cannot reliably show how dangerous the condition is or how well the treatment works.
Limitations
Very small sample size (5 patients), no control group, short follow-up, and it is a pilot study on a surgical technique rather than a study of the natural risks of pilonidal disease itself.
Taken word for word from the abstract
- n 5 patients with primary symptomatic pilonidal sinus underwent an operation as a pilot study
- population 5 patients with primary symptomatic pilonidal sinus
- intervention a narrow excision of pilonidal orifices with the subcutaneous destruction of the sinus tract and the removal of hair as well as the long-term vessel loop drainage of the wound channel
- comparator 5 patients with primary symptomatic pilonidal sinus underwent an operation as a pilot study
- primaryOutcome In order to assess the efficacy and morbidity of this method
- result No adverse events occurred such as abscess or recurrent pilonidal sinus.
- result One female patient with a history of long-term use of morphine derivatives and psychotropic substances experienced persistent coccygeal pain that persisted longer than 6 weeks.
- result The complete wound healing with the formation of a qualitative scar took place on the 21st postoperative day (for 3 patients) and on the 28th postoperative day (for 2 patients).
Surg Technol Int · PMID 27042792 · Read it on PubMed ↗
Kushwaha et al. 2015
A rare case of vulval pilonidal sinus: incidental diagnosis
Unusual site, no cancer found.Case seriesVery low qualityRelated question
1 people2015
the lesion was found to be a pilonidal sinus with no cancer or precancerous changes
Who was studied
a 63-year-old woman with vulval bleeding
What they received
surgical excision of the vulval lesion
Compared with
none
Main outcome
diagnosis of the lesion after removal
Quality
this is a single patient case report, so it cannot show how often pilonidal disease is dangerous in general.
Limitations
single case report; describes an unusual location (vulva) rather than the typical sacrococcygeal site
Taken word for word from the abstract
- n A 63-year-old woman presented with a 4-week history of vulval bleeding.
- population A 63-year-old woman presented with a 4-week history of vulval bleeding.
- intervention This vulval lesion was treated by surgical excision.
- comparator This vulval lesion was treated by surgical excision.
- primaryOutcome Histological analysis showed irregular pieces of skin partly covered by hyperplastic squamous epithelium.
- result There was no evidence of dysplasia or malignancy.
- result This chronically inflamed fistulous tract together with hair shafts within the wall of the tract were diagnostic of a pilonidal sinus of the vulva.
BMJ Case Rep · PMID 26216921 · Read it on PubMed ↗
Esposito et al. 2015
Squamous cell carcinoma and pilonidal cyst disease
Rare cancer risk from long-term cyst.Case seriesVery low quality
1 people30 months
no sign of cancer returning after 30 months
Who was studied
a 63-year-old patient with 43 years of recurrent pilonidal sinus disease
What they received
incisional biopsy, CT staging, and radical surgery
Compared with
none
Main outcome
cancer recurrence after treatment
Quality
this is a single patient case report, so it cannot show how common or dangerous this is in general.
Limitations
only one patient described; no comparison group; malignant transformation described as very rare overall
Taken word for word from the abstract
- n a 63- years-old patient with a 43 years history of recurrent pilonidal sinus disease
- population a 63- years-old patient with a 43 years history of recurrent pilonidal sinus disease
- intervention underwent incisional biopsy, staging with total body CT and, finally, radical surgery
- comparator The patient underwent incisional biopsy, staging with total body CT and, finally, radical surgery.
- primaryOutcome After 30 months there were no evidence of recurrence.
- result After 30 months there were no evidence of recurrence.
Ann Ital Chir · PMID 25693725 · Read it on PubMed ↗
Tengberg et al. 2015
[Pre-sacral cyst as differential diagnosis to recurrent pilonidal cyst with abscess]
Misdiagnosed cyst, not pilonidal diseaseCase seriesVery low qualityRelated question
1 people2015
The true cause was a pre-sacral epidermal inclusion cyst, not a pilonidal cyst; after proper excision the patient recovered without complications
Who was studied
A 31-year-old man with recurrent abscess in the gluteal cleft, initially diagnosed as pilonidal sinus
What they received
Imaging (endoscopy, MRI, transrectal ultrasound) to find the true cause, followed by surgical excision of a pre-sacral cyst
Compared with
Previous repeated pilonidal surgery (modified Bascom's technique)
Main outcome
Resolution of recurrent abscess/cyst after correct diagnosis and treatment
Quality
This is a single patient case report, so it cannot show how dangerous pilonidal cysts generally are.
Limitations
Single case report; the mass turned out not to be a true pilonidal cyst but a pre-sacral epidermal inclusion cyst misdiagnosed as pilonidal disease.
Taken word for word from the abstract
- population A 31-year-old man presented with a recurrent abscess in the gluteal cleft.
- intervention Endoscopy, magnetic resonance imaging and transrectal ultrasound visualized a pre-sacral cyst, which was excised in toto with laterosacral approach of Kraske.
- comparator The modified Bascom's asymmetric midgluteal cleft closure technique was used without satisfying clinical remission.
- primaryOutcome The post-operative course was uneventful.
- result A histological examination showed epidermal inclusion cyst.
- n A 31-year-old man presented with a recurrent abscess in the gluteal cleft.
Ugeskr Laeger · PMID 25612946 · Read it on PubMed ↗
Mengual-Ballester et al. 2014
[Presacral tumor as a differential diagnosis of recurrent pilonidal sinus]
Rare hidden tumor mimicked pilonidal cyst.Case seriesVery low qualityRelated question
1 people2014
Recurrent pilonidal sinus was actually a presacral cystic teratoma, removed surgically
Who was studied
22-year-old male with recurrent pilonidal sinus/cyst
What they received
Surgical removal of the tumor through the abdomen
Compared with
None
Main outcome
Final diagnosis of the underlying mass
Quality
This is a single case report, so it cannot show whether pilonidal cysts in general are dangerous.
Limitations
Single case; describes a rare presacral tumor misdiagnosed as pilonidal disease, not pilonidal cysts themselves.
Taken word for word from the abstract
- population a 22-year-old male with a pilonidal cyst operated due to recurrent pilonidal sinus cyst
- intervention The tumor was removed surgically through the abdomen
- comparator CLINICAL CASE: We report the case of a 22-year-old male with a pilonidal cyst operated due to recurrent pilonidal sinus cyst.
- primaryOutcome Final diagnosis after pelvic computed tomography is large retrorectal cystic tumor
- result diagnosis of cystic teratoma was established
- n a 22-year-old male
Cir Cir · PMID 25259438 · Read it on PubMed ↗
Iesalnieks et al. 2015
["Pit picking" surgery for patients with pilonidal disease : mid-term results and risk factors]
Most patients healed after minor surgery.Case seriesLow qualityRelated question
153 peoplemedian follow-up time of 30 months
74% of patients had no recurrence after a median follow-up of 30 months, and smoking and prior abscess were linked to higher recurrence risk
Who was studied
patients with pilonidal disease
What they received
minimally invasive 'pit picking' surgery under local anesthesia
Compared with
no comparison group
Main outcome
recurrence of pilonidal disease after surgery
Quality
This is a single-arm case series without a comparison group, so it shows outcomes after surgery but can't address whether the condition itself is dangerous.
Limitations
No control group, selected patient population, and the study focuses on surgical recurrence rather than on dangers of the untreated condition.
Taken word for word from the abstract
- population patients with pilonidal disease
- intervention All patients underwent "pit picking" surgery.
- comparator All patients underwent "pit picking" surgery.
- primaryOutcome disease recurrence after "pit picking" surgery
- result Of the patients 74% had no recurrence after a median follow-up time of 30 months and 8 more patients (5 %) remained asymptomatic after a second"pit picking" procedure.
- n A total of 153 patients (126 males) underwent "pit picking" surgery between June 2007 and November 2010.
- followUp median follow-up time of 30 months
Chirurg · PMID 24969346 · Read it on PubMed ↗
Ardelt et al. 2016
Microbiology of the infected recurrent sacrococcygeal pilonidal sinus
Recurrent cysts show different bacteria types.RetrospectiveVery low qualityRelated question
96 people2016
recurring sinus infections showed more gram-positive and aerobic bacteria than primary infections
Who was studied
patients with primary or recurring pilonidal sinus infections
What they received
swab samples taken from infected pilonidal sinus abscesses
Compared with
primary pilonidal sinus versus recurring pilonidal sinus
Main outcome
type of bacteria found (gram-positive/negative, aerobic/anaerobic)
Quality
This was a small, single-centre retrospective review of swab samples, not a study testing treatment or danger.
Limitations
Retrospective single-centre design; abstract does not describe clinical outcomes or complications, only bacterial flora.
Taken word for word from the abstract
- n 73 swab samples were taken from primary sacrococcygeal pilonidal sinus (pPS) and 23 swab samples of patients with recurring sacrococcygeal pilonidal sinus (rPS)
- population Microbiological findings of swab samples of abscess-forming PS from 2000 to 2010 were evaluated.
- intervention swab samples were taken from primary sacrococcygeal pilonidal sinus (pPS) and 23 swab samples of patients with recurring sacrococcygeal pilonidal sinus (rPS)
- comparator Pathogens of pPS are not always solely anaerobic or gram-negative, and those of rPS not always aerobic or gram-positive.
- primaryOutcome to define the changes in the microbiological flora of the recurring sacrococcygeal pilonidal sinus (PS)
- result Our results show a statistically significant shift of the bacterial flora towards the gram-positive range (P = 0·029) and a shift with tendency towards the aerobic range (P = 0·090).
Int Wound J · PMID 24758263 · Read it on PubMed ↗
Irkoren et al. 2013
Rare complication after VAC therapy in the treatment of tissue defect due to surgical excision of pilonidal sinus
Found harmCase seriesVery low quality
1 people2013
the patient developed squamous cell carcinoma that went undetected because the NPWT dressing was left in place for 5 days
Who was studied
a 60-year-old patient after surgical excision of a pilonidal sinus
What they received
negative pressure wound therapy (NPWT/VAC) on the open wound
Compared with
none
Main outcome
wound healing and detection of complications
Quality
this is a single patient case report, so it cannot show how often this happens or whether it applies to others.
Limitations
single case report with no comparison group; rare complication reported after a specific wound care technique, not pilonidal sinus itself.
Taken word for word from the abstract
- n a 60-year-old patient
- population after excision of a pilonidal sinus, which was managed postoperatively with NPWT
- intervention managed postoperatively with NPWT
- comparator CASE: We describe the case of a 60-year-old patient referred after excision of a pilonidal sinus, which was managed postoperatively with NPWT.
- primaryOutcome the patient developed squamous cell carcinoma, which was undetected postoperatively
- result the patient developed squamous cell carcinoma, which was undetected postoperatively, as the dressing was left in place for 5 days
J Wound Ostomy Continence Nurs · PMID 24202229 · Read it on PubMed ↗
Afşarlar et al. 2013
Treatment of adolescent pilonidal disease with a new modification to the Limberg flap: symmetrically rotated rhomboid excision and lateralization of the Limberg flap technique
New surgery technique healed without recurrence.Case seriesLow qualityRelated question
15 people4 months
no wound infection or recurrence during follow-up; one patient had a wound hematoma
Who was studied
teenagers having surgery for pilonidal disease on the lower back
What they received
a modified surgical flap technique (symmetrically rotated rhomboid excision with lateralized Limberg flap)
Compared with
no comparison group
Main outcome
wound infection and disease coming back after surgery
Quality
very small group of 15 patients, no comparison group, and only a few months of follow-up, so it cannot show how risky the disease itself is.
Limitations
Abstract itself states the number of patients was small and the follow-up period was short, and there was no comparator group.
Taken word for word from the abstract
- n A total of 15 adolescents (8 boys and 7 girls) were included in the study group.
- population All of the patients who were operated on for sacrococcygeal pilonidal disease were included in this study.
- intervention symmetrically rotated (clockwise) rhomboid excision and lateralization of the Limberg flap
- comparator descriptive prospective study to evaluate its efficiency
- primaryOutcome we did not encounter any wound infection or recurrent disease during this period
- result we did not encounter any wound infection or recurrent disease during this period. Only one patient had wound hematoma as a result of drain breakdown
- followUp The median postoperative follow-up period was 4 months (ranging from 1 to 12 months)
J Pediatr Surg · PMID 23932616 · Read it on PubMed ↗
de Parades et al. 2013
Pilonidal sinus disease
Review of surgery options, not danger.Narrative reviewLow qualityRelated question
size not given2013
the abstract describes treatment options and tradeoffs rather than reporting a dangerousness outcome; it notes the open-wound technique has a low recurrence rate but longer healing and activity cessation, while primary closure is less restrictive but likely has higher recurrence
Who was studied
people with pilonidal disease, a skin condition near the tailbone, usually young adults aged 15-30
What they received
surgical treatment (various excision and closure techniques)
Compared with
different surgical techniques compared to each other (open wound healing vs primary closure vs plastic reconstruction)
Main outcome
healing, recurrence, and recovery time after treatment
Quality
this is a narrative review describing the condition and surgical options without original data, patient numbers, or statistical comparisons.
Limitations
no original study data, no patient numbers, no formal outcome measures reported; abstract does not address danger or severity of the disease itself, only treatment approaches
Taken word for word from the abstract
- population Pilonidal disease is a frequent suppurative condition that occurs twice as often in men as in women, usually between the ages of 15 and 30.
- intervention In the large majority of cases, treatment is surgical but there is no consensus as to the 'ideal' technique.
- comparator Primary wound closure techniques are less restrictive but their recurrence rate is probably higher.
- primaryOutcome This technique has a low rate of recurrence but has the disadvantages of requiring local nursing care; the healing process is prolonged, usually associated with a temporary but prolonged cessation of activity.
- result data in the literature favor asymmetric closure techniques such as those described by Karydakis and Bascom.
J Visc Surg · PMID 23911903 · Read it on PubMed ↗
Özdemir et al. 2013
Sacrococcygeal foreign body progressing with pilonidal sinus clinical picture: report of a case
Rare case, foreign body caused recurring abscesses.Case seriesVery low qualityRelated question
1 people2013
a retained foreign body was found to be causing recurrent abscesses after three prior surgeries
Who was studied
a patient with long-term leakage and repeated pilonidal abscesses in the tailbone area
What they received
not applicable (case report describing a foreign body found in the area)
Compared with
none
Main outcome
finding the underlying cause of repeated abscesses and leakage
Quality
this is a single patient case report, so it cannot show how dangerous pilonidal cysts generally are.
Limitations
only one patient described; no comparison group; cause was an unusual foreign body rather than typical pilonidal disease.
Taken word for word from the abstract
- n This study presents the case of a patient with chronic leakage
- population a patient with chronic leakage who had a history of three surgical procedures due to recurrent pilonidal abscesses and the presence of a foreign body in the sacrococcygeal area
- intervention This study presents the case of a patient with chronic leakage who had a history of three surgical procedures
- comparator CASE REPORT
- primaryOutcome The presence of a foreign body in cases progressing with a single and wide inlet and frequently recurring abscess formation is a condition of which to be aware.
- result the presence of a foreign body in the sacrococcygeal area
J Emerg Med · PMID 23871483 · 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 2026-10-13
The exact search — paste this into PubMed to repeat it: ("Pilonidal Sinus"[Mesh]) AND (complications[sh] OR "natural history" OR prognosis[tiab] OR abscess OR sepsis OR "malignant transformation" OR carcinoma OR pregnancy[tiab]); PubMed expanded that to: "Pilonidal Sinus"[MeSH Terms] AND ("complications"[MeSH Subheading] OR "natural history"[All Fields] OR "prognosis"[Title/Abstract] OR ("abscess"[MeSH Terms] OR "abscess"[All Fields] OR "abscesses"[All Fields] OR "abscessation"[All Fields] OR "abscessed"[All Fields] OR "abscessing"[All Fields]) OR ("sepsis"[MeSH Terms] OR "sepsis"[All Fields]) OR "malignant transformation"[All Fields] OR ("carcinoma"[MeSH Terms] OR "carcinoma"[All Fields] OR "carcinomas"[All Fields] OR "carcinoma s"[All Fields]) OR "pregnancy"[Title/Abstract])
What came back: 558 records found · 200 read · 63 answered the question
Included: Human, animal or laboratory studies reporting an outcome relevant to the question
Excluded: Records about a different condition or intervention
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.

558records came back from the search
200were read
63actually answered the question

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

The cyst sits in a private area, so embarrassment can delay seeing a doctor about it.
Early on it can look like a small bump or ingrown hair, so it's easy to assume it isn't serious.
Fear of surgery or a visible scar near the tailbone makes people search for reassurance instead of getting it checked.
During pregnancy, people may worry that treatment or imaging could affect the baby, so they delay care and look for answers online instead.

Common questionsShort answers, drawn from the same studies.

Is a pilonidal cyst dangerous?: For most people, no — it's a painful but treatable lump near the tailbone. Some develop an abscess needing drainage, and very rarely, after many years, it can turn into skin cancer, but large studies suggest serious outcomes are uncommon.
Is a pilonidal cyst dangerous in pregnancy?: No study in this review followed pregnant people with a pilonidal cyst, so there's no research-based answer specific to pregnancy. If you're pregnant and have a painful or draining cyst, tell your obstetric provider so it can be checked and treated like any other infection.
Is an infected pilonidal cyst dangerous?: An infected cyst (abscess) usually needs drainage and sometimes antibiotics; studies show this is a common complication rather than a typical life-threatening one. In rare, documented cases the infection has spread more seriously, including toward the spine or abdomen, so worsening pain, fever, or feeling very unwell needs prompt medical attention.
What should I do instead of waiting it out?: See a doctor or urgent care rather than trying to drain it yourself; abscesses are usually treated with incision and drainage, sometimes with antibiotics. Watch for spreading redness, fever, or feeling unwell, since case reports show an untreated spreading infection can occasionally become serious.
Can a pilonidal cyst turn into cancer?: Yes, but it's very rare. In the largest study to look at this, cancer was found in only about 1 in 800 removed chronic cysts, almost always after the cyst had been present for many years.

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.

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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.