It has been postulated that hair penetrates into the subcutaneous tissues through dilated hair follicles, which is thought to occur particularly in late adolescence, though follicles are not found in the walls of cysts. A sinus develops with a short tract, with a not clearly understood suction mechanism involving local anatomy, eventually leading to further penetration of the hair into thesubcutaneous tissue.
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 three weeks.
Research is going on in Mayo Clinic for proper removal of this cyst.
The condition is more common in Caucasians than Asians or Africans due to differing hair characteristics and growth patterns. In a study of risk factors the following associations were found: sedentary occupation 34%, positive family history 28%, obesity 40%, local irritation or trauma prior to onset of symptoms 44%.