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Beverly Hills · 435 N. Bedford Dr., Suite 308Mon–Fri 9:00 am – 5:00 pmMost PPO insurance accepted
Allen KamravaMD · MBA · FACS · FASCRS

Procedure

In office

Pilonidal Cyst Curettage

A smaller pilonidal procedure: the sinus tract is opened, cleared of hair and debris, and scraped clean under local anesthetic — no large excision, though the tract takes time to close fully.

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Setting
In office
Anesthesia
Local anesthetic
Back to work
Most people are back to normal activities within a few days
Success rate
85-95%
Recurrence
5-15%

What it is

What is Pilonidal Cyst Curettage?

Pilonidal Cyst Curettage is a minimally invasive surgical procedure for the treatment of chronic pilonidal sinus disease. The procedure involves making a small incision to drain any abscess, followed by the removal of hair and debris from the sinus tract. The tract is then thoroughly debrided and scraped clean using a curette, a specialized surgical instrument. The wound is typically left open to heal by secondary intention, which minimizes the risk of recurrence. This procedure is less invasive than wide excision and is often performed in an outpatient setting under local anesthesia.

Am I a candidate?

Who is a Good Candidate for This Procedure?

Ideal candidates are patients with chronic or recurrent pilonidal sinus disease who do not have a large, acute abscess. It is a good option for patients who wish to avoid a more extensive excision with a longer recovery period. This procedure is particularly suitable for patients with a single or a few sinus tracts without extensive branching. Patients who prefer a procedure that can be done under local anesthesia in an office or outpatient setting are also good candidates.

How it's done

  1. 1Numbing — the area is numbed with local anesthetic.
  2. 2Opening — a small opening is made over the sinus, and any trapped fluid or pus is drained.
  3. 3Cleaning — hair and debris are removed from the tract, and its lining is scraped clean with a curette (a small scooping instrument).
  4. 4Healing — the small wound is usually left open under a light dressing to heal from the inside out, which avoids sealing infection back in.

What to expect

  1. Same day

    Home shortly afterward with a light gauze dressing.

  2. First week

    Keep the area clean — gentle showers or sitz baths and fresh dressings. Some drainage is normal and expected.

  3. Following weeks

    The tract closes gradually from the inside out. Keeping the area clean and free of hair is the main job — it is what protects against recurrence.

  4. Follow-up

    Office checks to confirm the tract is healing closed.

Risks & considerations

What are the Risks?

While pilonidal cyst curettage is a safe procedure, potential risks are possible, though generally less frequent and severe than with more invasive excisions. Risks include:

  • Recurrence: The pilonidal sinus may recur if not all hair and granulation tissue is completely removed. Rates are generally low but can be higher than with more extensive flap procedures.
  • Bleeding: Minor bleeding or spotting from the wound is common in the first few days. Significant bleeding is rare.
  • Infection: A wound infection can occur, particularly if the wound is closed primarily. Leaving the wound open to heal significantly reduces this risk.
  • Pain: Postoperative pain is expected but is typically mild and manageable with over-the-counter pain relievers and warm sitz baths.
  • Delayed Healing: The wound is left open and can take several weeks to heal completely. Proper wound care is essential to ensure good healing.

Sources

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