You can try sitz baths for a while, but most pilonidal cysts, sinuses or abscesses need to be incised, irrigated and drained. Surgeons used to attempt to close the incisions with stitches, but many re-opened because of residual infection. Most incisions are now left open to heal slowly. Sounds gross, but it works.
Many pilonidal abscesses spread along several sinus tracts, so it is best to bite the bullet and have the surgery sooner than later. Smaller cuts heal faster than longer and deeper ones.
What is the best way to get rid of a pilonidal cyst?
Antibiotics do not heal a pilonidal cyst. Doctors have any of a number of procedures available, including the following treatments.
The preferred technique for a first pilonidal cyst is incision and drainage of the cyst, removing the hair follicles, and packing the cavity with gauze.
Advantage - Simple procedure done under local anesthesia
Disadvantage - Frequent changing of gauze packing until the cyst heals, sometimes up to 3 weeks
Marsupialization - This procedure involves incision and draining, removal of pus and hair, and sewing of the edges of the fibrous tract to the wound edges to make a pouch.
Advantages - Outpatient surgery under local anesthesia, minimizes the size and depth of the wound without the need to pack gauze in the wound
Disadvantages - Requires about 6 weeks to heal, needs a physician trained in the technique
Another option is incision and drainage with immediate closing of the wound.
Advantages - Wound completely closed immediately following surgery without need for gauze
Disadvantages - High rate of recurrence (It is hard to remove the entire cyst, which might come back. Typically performed in an operating room, it requires a specially trained surgeon.)
Reply:you need to be evaluated by a medical doctor to see if drainage or removal is warranted. sometimes they drain on their own, but the cyst sac still remains and can refill at any time.good luck;)michele