A pilonidal cyst and an anorectal abscess

A matching description of pain or drainage does not name which lump it is. ahem has not examined anyone. The abscess pages on their own are an anorectal abscess.

Mayo Clinic says a pilonidal cyst is an unusual pocket in the skin that usually contains hair and skin debris, almost always near the tailbone at the top of the buttocks. Loose hairs puncture the skin. Friction from rubbed skin, tight clothing, cycling, or long periods of sitting can force hair in. Cleveland Clinic's pilonidal page, last updated July 6, 2020 and opened October 28, 2026, places the cyst in the crease of the buttocks, anywhere from the tailbone to the anus, and describes ingrown hairs and a skin infection. It says more than 70,000 cases are reported in the United States every year. Mayo Clinic does not print that count.

MedlinePlus, reviewed April 11, 2026 and opened October 28, 2026, calls an anorectal abscess a collection of pus in the area of the anus and rectum. Common causes it names are blocked glands in the anal area, infection of an anal fissure, a sexually transmitted infection, and trauma. Cleveland Clinic's abscess page, last updated June 17, 2022, says the lump is near the anus, rectum, or the space between the genitals and the anus, and that it starts when an anal gland is clogged and infected. The pilonidal pages are about a hair pocket in the crease. The abscess pages are about pus at the anus.

Mayo Clinic's pilonidal risk list is being a young adult white male, being overweight, an inactive lifestyle, sitting for long periods, and thick, stiff body hair. It says pilonidal cysts are most common in young adult males and tend to recur, and that people who sit for long periods are at higher risk. Cleveland Clinic says men are three to four times more likely to be diagnosed than women, that the ages run from puberty to 40, and that the average age is between 20 and 35. Those two sex sentences are each page's own. This guide does not merge them into one rate.

MedlinePlus says an anorectal abscess affects men more than women, and that it may occur in infants and toddlers in diapers who have had anal fissures. Cleveland Clinic's abscess page says the problem is most common in men and more likely between the ages of 20 and 60. The infant line is MedlinePlus. The 20-to-60 span is the abscess page, not the pilonidal age line above.

Mayo Clinic says a pilonidal cyst may cause no symptoms until it is infected. Infected symptoms on that page are a pit near the top of the buttocks crease, pain, inflamed and swollen skin, pus or blood leaking from an opening, and an odor from draining pus. It says to see a health care provider if you notice any symptoms.

Cleveland Clinic's symptom list is pain that often gets worse when sitting, a small dimple or a large swollen area between the buttocks, and an abscess with draining pus or blood that may smell foul. It says to get medical attention quickly for those symptoms, and it adds nausea, fever, and extreme tiredness. A warm compress is the comfort step it names while waiting for treatment. It also names an inflatable seat or mattress as a way some people feel less pain. Mayo Clinic's pilonidal pages do not describe that seat.

Mayo Clinic says a pilonidal cyst is usually treated in the office. After numbing the area, the clinician makes a small cut to drain it. If the cyst returns, surgery may remove it. After removal, one option is to leave the wound open and pack it so it heals from the inside out. Mayo Clinic says that takes longer and makes the cyst less likely to come back. The other option is to close the wound with stitches, which it says has a shorter healing time and a greater risk of the cyst coming back. The page does not give those healing times in days. Wound care, dressing changes, and shaving around the site so hairs do not enter the wound are part of what the clinician explains.

Cleveland Clinic says antibiotics can treat skin inflammation and cannot heal pilonidal cysts on their own. It also names office drainage, phenol injections for mild and moderate cysts, and laser hair removal aimed at hairs that might become ingrown. It does not print a phenol strength on the page opened October 28, 2026. For a chronic cyst or a sinus cavity under the skin, it says surgery may remove the cyst, and the surgeon might leave the wound open for packing, close it with sutures, or use a skin flap.

An anorectal abscess is drained too, and the details differ. MedlinePlus says the problem rarely goes away on its own, antibiotics alone usually cannot treat it, and treatment is surgery to open and drain it, often the same day, with the wound usually left open and no stitches. Cleveland Clinic's abscess page says not to pop it. It says some abscesses are cared for with warm compresses and sitz baths, and that some clinicians allow one to drain on its own. On that page, checked October 28, 2026, a drained abscess takes three or four weeks to heal, and, according to the American Society of Colon and Rectal Surgeons as Cleveland Clinic cites it, about half of people who have an anal abscess develop a fistula.

Cleveland Clinic says pilonidal cysts sometimes drain and disappear on their own, and that chronic cysts can come and go. Mayo Clinic's treatment page describes office drainage and surgery if the cyst returns, and its symptoms page says to see a clinician for any symptoms. MedlinePlus says an anorectal abscess rarely goes away on its own. Those three sentences are about two different lumps. They are not one rule for both.

Mayo Clinic says that without treatment, people with pilonidal cysts that become infected again and again may have an increased risk of a skin cancer called squamous cell carcinoma. Cleveland Clinic says a pilonidal cyst is not fatal in itself, that squamous cell carcinoma is rarely caused by one, and that it can sometimes happen. It says a clinician who diagnoses a pilonidal cyst will usually test a sample of pus. The repeated-infection warning is Mayo Clinic's. The word rarely is Cleveland Clinic's.