Why Is a Pilonidal Cyst Not Really a Cyst?

Why is a pilonidal cyst not really a cyst?

A cyst is an epithelial lined sac (like your skin or inside your cheek) that has been present since you were an embryo.  Pilonidal disease is not pilonidal cyst disease because it’s an acquired condition.  Pilonidal disease (AKA pilonidal cysts) are not congenital.

There’s no such thing as a pilonidal cyst!

While many doctors and patients commonly call the condition a ‘pilonidal cyst’, the term is a misnomer and indicates a misunderstanding of the disease. 

Why isn't it really a pilonidal cyst?

For the term ‘pilonidal cyst’ to be correct, there must be an infected glandular cyst present, which is lined by epithelium (like skin). However, cysts are not present in pilonidal disease and there is no such thing as a ‘pilonidal cyst’.  People who develop pilonidal disease are not born with it (congenital theory), they acquire it, likely by trauma in someone who is prone to the condition.

So, what is pilonidal disease?

Those who properly understand pilonidal disease realize that it is really an abscess of the skin and subcutaneous tissue (the tissue under the skin) of the natal cleft.

WebMD, the Mayo Clinic, and Wikipedia all incorrectly use the term ‘pilonidal cyst’ rather than ‘pilonidal disease’ and refer to surgical procedures for this problem as pilonidal cyst surgery.

Why does the misconception that pilonidal disease is really pilonidal cyst disease create a problem?

Surgeons who operate on pilonidal disease believing that it is caused by a congenital cyst have the wrong game plan for the operation.  Often, these surgeons excise a large amount of normal tissue in order to fully excise this ‘cyst’.  They may leave the wound open or close it under tension and covering over dead space (empty space under the surface that typically fills with infected fluid).  Often the open wounds don’t heal and the closed wounds open up, both creating a big problem.

Please read more about the wrong and proper operations for pilonidal disease here.

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