About Pilonidal Sinus
The physiologic causes of pilonidal sinus are not fully understood, but there are a few theories. One theory suggests that hair growing in the crease of the buttocks, or natal cleft, can lead to trapped hair follicles and bacteria entering the skin, causing inflammation and abscess formation. Another theory suggests that the disease is acquired and is caused by a chronic inflammatory response to the retention of hair follicles in the intergluteal cleft, leading to abscesses and multiple fistula tracts.
Non-modifiable risk factors for pilonidal sinus include:
- Gender: Pilonidal sinus is more common in males.
- Age: The disease mainly affects teenagers and young adults.
- Hair: Increased density of hair or stiffer hair increase the risk of pilonidal disease.
- Polycystic Ovary Syndrome (PCOS).
- Family history of pilonidal sinus or similar conditions.
Modifiable risk factors for pilonidal sinus include:
- Poor hygiene: Not maintaining proper cleanliness in the area can increase the risk.
- Obesity: Being overweight or obese can contribute to the development of pilonidal sinus.
- Sedentary lifestyle: Prolonged sitting or lack of physical activity may increase the risk.
It's important to note that these risk factors may not guarantee the development of pilonidal sinus, but they can increase the likelihood. Maintaining good hygiene and a healthy lifestyle may help reduce the risk.
The most common early symptoms of pilonidal sinus include:
- Small dimple in the skin.
- Irritation or discomfort in the affected area.
- Red, tender area.
As pilonidal sinus progresses or reaches a higher severity, other common symptoms may occur:
- Painful mass, which may be an abscess.
- Drainage from the area, which may be a clear, cloudy, or bloody fluid.
- Foul-smelling pus.
- Fever.
- Nausea.
Rarely, pilonidal sinus may have a link to osteomyelitis (inflammation of the bone) or skin cancer. However, these are rare complications. It's important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment.
To diagnose pilonidal sinus, the following examinations, tests, and procedures may be performed:
- Medical history: Gathering information about your symptoms and previous diagnoses can help in the diagnostic process.
- Physical exam: The healthcare provider will look for physical signs such as pain, swelling, or the presence of masses in the affected area.
Additional examinations, tests, and procedures may include:
- Imaging studies: CT or MRI scans may be recommended to get a better view of the sinus tract and surrounding tissues.
- Lab tests: Blood tests can help rule out other conditions and assess your overall health.
- Clinical procedures: These may include biopsy or drainage of the sinus tract to obtain a sample for further examination.
It's important to follow up with your healthcare provider if your symptoms worsen or change after the initial examination. They may recommend further tests or procedures based on your specific situation. Remember to consult with your healthcare provider for personalized advice.
The goals of treatment for pilonidal sinus are to accelerate healing, decrease pain, and reduce the loss of productive work hours. Here are the different treatment options and how they work to achieve these goals:
Medications:
- Pain medication: Over-the-counter pain relievers can help manage pain associated with pilonidal sinus. However, it is important to consult with your healthcare professional before taking any medication, especially if you have other medical conditions or are taking other medications.
- Antibiotics: Antibiotics are generally only necessary if there is a skin infection surrounding the pilonidal sinus.
Therapeutic Procedures:
- Abscess drainage: If an abscess is present, a doctor will need to drain it. This procedure is typically done in a doctor's office under local anesthesia. It helps reduce inflammation and allows the pus to drain away.
- Sinus excision: Many people will have ongoing problems with pilonidal sinuses. In these cases the pilonidal sinus will need to be removed or filled. There are multiple approaches that can be used, and the best approach will be tailored to the individual patient.
Self-care and health behavior changes:
- Hair removal: Regular hair removal from the affected area may help prevent future issues and reduce the need for surgical procedures. Hair removal options include shaving, waxing, laser removal, and epilation creams. However, it is important to be cautious with certain techniques that may cause irritation or rashes.
It is important to note that treatment options may vary depending on the severity of the condition and individual circumstances. Consulting with a healthcare professional is recommended to determine the most appropriate treatment approach for pilonidal sinus.
Medication dosing may be affected by many factors. Check with your healthcare professional about dosing for your individual situation. Side effects can occur. Check with your healthcare professional or read the information provided with your medication for side effect information.