The 'cyst'erhood of 04


Has any body heard/ found/ researched out very strange cyst problem of 04. At last count I know of 8 or so hikers who came down with them, myself included. So far there seems to be no connection with diet/ gear/ timing. If you have any news please post as it my be helpful for the class of 05.

For thoes of you who haven’t heard about the problem. Several of us came down with cysts this past year. Cysts were usually on the back/ butt/ or thighs. These were very painful (especially if on the back) and potentially dangerous if not treated with antibiotics (Southpaw ended up with a fever). It basically started like a big zit and got larger from there if not treated, many of them were reoccuring. I did find out that it was bacterial, this is why, without clean clothes to change into, they were reoccuring.

Thanks for the input.
mountain mamma

mountain mamma


My people call them BOILS.

Kind of like a pimple gone space alien wild.

Quite common, actually, but they can become infectious monsters and even life-threatening if left untreated. The creamy pus inside is highly dangerous, too. It can spread infection to any part of the body it contacts.

Personal hygiene is good prevention.
Wash yourself and be happy.:nerd

Butt Volcano


Run a google on pilonidal cyst. They are probably more common than you think.

been there


I am a practicing surgeon. The cysts I believe you are referring to are known as “sebaceous cysts”. They can occur anywhere on the body and are formed by plugged off oil glands. Commonly they are on the back(and in hikers probably partly brought on by the pack covering your back, the sweating and the relative lack of cleansing of the area). You may feel a small lump or “kernel” and eventually it gets infected and then swells up and becomes painful. It either spontaneously drains or is lanced at the doctor’s office. I like to say its the equivalent of a zit times a million, but deeper and harder to pop. A pilonidal cyst is something different, and occurs specifically in the area of the tailbone, and rarely in the belly button. It has been known as “jeep driver’s” disease in WW2, because it seems related to the bouncing of the tailbone in the seat of the jeep, but it actually may also be related to hair ingrowth in that area of the body. I would be happy to answer other questions if you have any about this.



I have had one for years on the base of my talebone. I lance it periodically and it goes away if you keep clean. Thanks for the anonymity of the internet because I would have never admitted that to my friends around here. Ironically I was just thinking about what I would do on the trail if it came back.



I developed poison ivy on the back of my thigh at Hot Springs and by the time I got to Erwin it had turned into cellulitis that had to be treated in the hospital with an antibiotic, prednisone, etc. I took a zero at Miss Janet’s (Thanks, Miss Janet!!!) and then slack packed for two days so I could come back and get clean each evening. It was a massive infection, but I’m not sure if it’s somehow connected to this cyst thing. If anyone is collecting data, though, for infection control purposes, please feel free to contact me. There were also many of us who developed “hiker crud,” large red rashes where things stayed warm and moist, even under my watch band until I figured out to loosen it at night. This was treated by trying to stay clean and by applying anti-fungal ointment daily. Makes you appreciate a good shower, doesn’t it?



After having many weeks with “da boils” here is my experience. Anyone who has been around them knows they aren’t fun, they are painful, and once infected can leave you feeling tiered and feverish like fighting the phlu. We had a culture done on “da boils” and found out (with no surprise) they were an antibiotic resistant staph - MRSA - methicillin-resistant Staphylococcus aureus.
No wonder that they took so long to get rid of… While hiking in NZ after the PCT they kept coming back again and again even with antibiotics and cleaning. A friend I was traveling with put me on a 2 week dose of augmentin, which got rid of them. The boils were very contagious after I got them after the PCT and they were passed on again and again to 3 other people… My friends who got the boils just got home to the states and went on sulphar based antibiotics, we will see if those work better than a long dose of augmentin.
Like many people I’m going to try and be as clean as possible on my next thruhike but still I am worried that they will come back under times of stress.

here is one about over an inch wide that was on my back that is now a scar- (its gross)



Yeah, yeah, yeah… I know the cleaning thing, I know the fact that it’s called a boil or sabecous cyst but here’s my question.


Talk to the Saufleys, talk to Meadow Mary, Poohs corner, anyone on the PCT who helps out on a regular basis. This is something strange that happened in great numbers this year as compared to years past. I truly don’t believe we were ‘dirtier’ this year than hikers in past years.

mountain mamma


To the hiker with the pilonidal cyst – the best way to get rid of it permanently is to see a surgeon who can remove the cyst. It is an outpatient procedure, and depending on the surgeon will either close the wound, or leave it open to heal in by scarring. I prefer to leave them open as it lessens the risk of infection after surgery and I think reduces the likelyhood of recurrence. The downside is it takes longer to heal ( like 2-4 months) so I’d get it done asap after hiking season is over. If you get caught out in the woods with it, Drainage is the primary treatment of any infected body part, so if you can get it open adequately to allow it to drain, it would allow you to hike on until you can stop in a town, which is pretty much what you would be doing anyway, if not drained, so that you could get someone to wield the knife on it.

MRSA infections are a big problem for my profession and have emerged over the last 2-5 years in increasing numbers. The infected skin is more painful and more red than the usual staph infection, and most antibiotics will not solve the problem, AUGMENTIN included (it is a penicillin with an additive to make it more potent). Sulfa based (Bactrim, Septra) are tried but the only good oral med is very expensive, called ZYVOX. Most likely the reason your infection cleared on augmentin was that the infection was well drained. These infections are deep in the skin and are not the same as the post discussing hiker rash or poison ivy allergic reaction/cellulitis which are on the skin surface and are treated medically and much differently.



And you are probably right, mountain momma, that it is different than in previous years. The problem is that the bacteria involved and transmitted in the infection is more virile and more difficult for the body to handle. No doubt, some hikers get “pimple” type staph infections all the time, but they just scrape em open, pop the zit, whatever, and that drains it and nothing more occurs so we didnt hear about it. This new bacteria is causing more problems, though, so you hear about it more. There have been some sports teams (wrestlers in particular) who have developed these and the skin to skin contact seems to be the mode of transmission. So wearing clean clothes would be the best protection from recurring infection in a hiker. Thats why I try to bring 2 shirts to hike in, trade them off on alternate days, and a 3rd shirt to sleep in when i’ve cooled off and not sweating anymore. The hiking shirts need washed every town stop and thoroughly dried. The use of hand sanitizer would also probably help in the instance of an existing infection but its pretty much impossible to keep hands totally “clean” while hiking, so I just try best to rinse em off when I can, and be careful to avoid skin contact with others and their equipment.



So is this something that is potentially going to grow in numbers in future years?!

mountain mamma


yes, scary isnt it?..And it is the result of too many patients demanding/too many docs giving/too many drug companies pushing use of/ antibiotics for non bacterial infections where they will do no good, and will only produce resistant bacteria. ( Things such as head colds, most cough/congestion/sinus allergies etc are caused by virus or allergen but not bacteria, and the only treatment should be rest, food, fluids.) Unfortunately, in our malpractice ridden society, it is better to give someone a weeks worth of antibiotics, have the cold go away(it would have anyway)and you are the hero, versus not give them anything, have it once in a million be something worse, and then get sued for a few million.



Last June at Keneddy Meadows we had to use a raw potato duct taped to one of these nasty cysts. It helped with drawing out the pus! Another feller a few years ago had no potato and just kept washing it with white gas to keep it clean. Anyone remember the “potato guys name”?

meadow ed

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Cutman 11, thanks for your professional input here. I think that with the increase of hikers using hostels,sharing spacesetc. a mini-epidemic has occured both with the cyst problem as well as Giardia. Several of this year’s NOBO on the AT have already been ill from Giardia type ailments(and there are only like 4 or 5 on the AT thus far)Its great that folks have inexpensive places to take time off but aspects of trail life(like hiker boxes) can be incubators for resistant forms of bacteria. Think of all the hands that sort through hiker boxes and what might be invisibly hidden under nails etc. It reminds me of a lyric from the late Frank Zappa-"take me away to the whispery places where they keep all the imaginary diseases. A solution could be to use hand sanitizers(handi-wipes) and have some Betadine liquid soup in a bounce box for more through scrubbing down. Another hiker ailment is infectious cellulitis which is a bacterial infection that can become recurrent, if the possible affected area is not keeped clean. Hikers who have lost are not dev. some of the inner abductor muscles are prone for this.



I guess we could put some type/kind of disenfencent in at least some of the hiker boxes. One thing for sure about hikers sorting thru H/Bs is they tend to hit that 1st when thet get to town even before they get their own boxes and or shower. Would throwing in bottles of ???help outlike at anza, Donnas ,K/Ms etc.



Yeah, it’s so good to be part of a dubious group. I was one of the first to get one and laid up for a week at the Saufley’s, so I take umbrage to the idea that cysts are contagious because that would implicate me in the rash of cysts that plagued PCT hikers this year. One big reason I think cysts are more prevalent is because of the changes in gear. Less padding on the new lines of backpacks means more irritation and closer (read close-pored) contact with the skin. My sebaceous cyst happened on a part of my lower back that had previously been rubbed raw and irritated by my pack (Go-Lite Breeze). I also got another one higher up my back later on. The cysts ceased when I packed and wore cotton t-shirts underneath my normal hiking shirt. I made extra effort to keep those shirts clean and had no more problems the rest of the hike. The scars on my back are a permanent reminder of the fun, good times and participation in an epidemic on the PCT in 2004.


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Just came back home from Tasmania Australia. We were hiking in the cradle mountain area and I developed pilonidal cyst within the day of hiking. Wondering the same. The relationship between the cyst and the hike.


I have heard of the potato treatment. Many fellow “cysters” are using it stop or reduce the impact.

I have heard of castor oil, alovera, tumeric etc too. Apparently they all help in redusing the impact.