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Bleeding cyst on the tail bone. Treatment?

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Internal Medicine Specialist
Practicing since : 1998
Answered : 1579 Questions
I think I have a sacral dimple... I was sitting in an extremely uncomfortable position at work for a few day and it was making my tailbone sore... I noticed blood on the toilet seat and cleaned up the area near top of the cleavage of the buttocks there was an indentation, I obviously can't get a good look to see how XXXXXXX it is, but I'm terrified it's a spinal condition like spina d... can't remember the spelling at the end that was overlooked, I'm 26
Posted Sun, 29 Apr 2012 in Bones, Muscles and Joints
Answered by Dr. Jasvinder Singh 5 hours later
Thanks for posting your query.

The symptoms that you have described are suggestive of a pilonidal cyst. It is a cyst that develops along the tailbone (coccyx) and it may present with redness and pain over the area and drainage of pus from an opening in the skin (sinus tract) over the lower spine.

Mostly, it is a dimple or sinus tract that has not become infected or inflamed and in that case you do not generally require any immediate treatment. Howeve, an infected pilonidal cyst is an abscess that requires incision and drainage in order to improve the symptoms.

I would suggest that you consult a surgeon who can examine you and prescribe appropriate therapy. Till that time, I would suggest the following:
•     Eat a high-fiber diet
•     Use a stool softener. You can try Tablet Colace 1-2 tablets daily.
•     Take a pain killer. You can take Tablet disprin 325 mg every 6 hours with meals.
•     Take a sitz bath for your symptoms.
•     Apply calamine lotion at the site
•     Keep the area clean and well moisturized
•     Wear loose, comfortable clothes
•     Maintain good personal hygiene.

Hope this answers your query. If you have additional questions or follow up queries, then please do not hesitate in writing to us.

Please accept my answer in case you have no follow up query.

Wishing you good health.


Above answer was peer-reviewed by
Follow-up: Bleeding cyst on the tail bone. Treatment? 16 minutes later
Dr. Jasvinder XXXXXXX

Thank you so much for your answer! I just have an additional question or two. I've had no redness, swelling or pain in the area nor have I yet aside from when I was sitting in a horrid position in my chair. As long as I've known about this sinus in that area it's never caused a problem until now and only bled after agitated from sitting. I guess my main question is if it's safe to wait a month or so due to my new job (which are very hard to come by anymore) and a previous vacation planned. I just don't want to overlook the condition temporarily and end up with some major complication or potentially fatal results.

Are there any solutions with minimal recovery time? You have to understand that I've been offered a once in a lifetime opportunity with a company that I've been waiting for a long time to receive and I'm positive that prolonged absence from work will result in myself being replaced due to the need for my position in the company.

- I think it may be more of a pilonidal dimple than a sinus after some online research. I'm in no way challenging your expertise, I'm just trying to better describe it.
Answered by Dr. Jasvinder Singh 11 hours later

Thanks for writing back.

I can understand your concern for the new job and our best wishes are with you. You can wait for some time till you get settled in your new job and can consult your doctor. But if the symptoms worsen then you may need an urgent referral.

Regarding pilonidal dimple, it is a hole near the base of spine and is a small pit or sinus in the sacral area at the very top of the crease between the buttocks. The pilonidal dimple may also be a XXXXXXX tract, rather than a shallow depression, leading to a sinus and then it may drain.

Another possibility for such symptoms if you are having any pain or lump in the anal area can be an external hemorrhoid. Symptoms of external hemorrhoids may include painful swelling or a hard lump around the anus which may itch. If you are having such symptoms, then this possibility should also be evaluated.

Hope this answers your query. If you have additional questions or follow up queries, then please do not hesitate in writing to us.

Please accept my answer in case you have no follow up query.

Wishing you good health.

Above answer was peer-reviewed by
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