What causes pilonidal sinus disease?

The accurate cause of this condition is unknown, but its cause is presumed to be a combination of changing levels of hormones (since it happens after puberty), hair growth, friction from clothes, or sitting for long periods of time.

Friction and pressure like skin rubbing against skin, tight clothing, bicycling, sitting for long periods of time forces the hair down into the skin. As a response to the hair as a foreign substance, the body forms a cyst around the hair. A person can sometimes have multiple sinuses that connect under the skin.

What are the symptoms of pilonidal sinus?

When a pilonidal cyst is infected, it becomes a swollen mass (abscess). The symptoms of an infected pilonidal cyst also include the following:

• Pain, redness, and swelling at the base of the spine
• Pus or blood oozing from an opening in the skin
• Bad smell from the pus that has oozed out
• Fever

What are the risk factors for pilonidal sinus disease?

Several factors can make people more vulnerable to developing pilonidal cysts, among them are:

• Young age (pilonidal cysts are normal in people who are in their 20’s)
• Obesity
• Sedentary lifestyle
• Occupations that require sitting longer
• Excess body hair
• Stiff or coarse hair

What are the complications linked to pilonidal sinus disease?

When recurrent infected pilonidal cysts are not treated for a long time, people can have a slightly higher risk of developing a kind of skin cancer called squamous cell carcinoma.

How is a pilonidal sinus diagnosed?

The doctor will start by performing a complete physical exam. During the exam, they will check the line of the buttocks for signs of a pilonidal cyst.

When people have a pilonidal cyst, it should be noticeable to the naked eye. If the doctor can spot a pimple or a dripping cyst, they may ask a number of questions to the patient, including:

• If the cyst has changed in appearance?
• Is it discharging any fluid?
• If the patient has any other symptoms?

At times, though rare, the doctor can ask for a CT or MRI to look for any sinus cavities (small holes) that might have formed below the surface of the skin.

How are pilonidal sinuses treated?

When people are diagnosed with one or more pilonidal cysts, they will receive a treatment plan that best suits each individual case. This treatment depends on the answers to many questions such as:

• If they already had a pilonidal cyst before?
• If they have had any other skin problems (such as abscess or sinus) in the same area?
• How fast are they recovering?

Depending on the severity of the symptoms, people might or might not require surgery to remove the pilonidal cyst. There are many other treatments available

Draining the cyst - this procedure can be done at the doctor’s office. A tiny cut is made to open and drain the fluid from the infected cyst.

Injections - injections might cure mild to moderate pilonidal cysts.

Antibiotics- antibiotics can cure skin inflammation. However, antibiotics cannot cure pilonidal cysts on their own.

Laser Therapy - Laser therapy can remove hair that otherwise can become ingrown, resulting in pilonidal cysts.

Surgery - if people have recurrent pilonidal sinuses or more than one sinus tract, the doctor can advise surgery. Initially, local anaesthesia will be administered to the patient. The surgeon then opens the lesions, draining all the pus and debris. Once this procedure is complete, your surgeon will close the wound with stitches. After the surgery is completed, the doctor will explain the method to change the dressings and advise shaving the site to prevent hair growth into the wound.

How can pilonidal sinus be prevented?

People can prevent chronic pilonidal sinus by washing the buttocks area daily with mild soap, making sure that all the soap is removed, keeping the buttocks area completely dry, and avoiding sitting for longer hours.

Conclusion

While pilonidal cysts are not dangerous, they can become difficult to treat and convert into a chronic condition when people do not seek help quickly, which is why people need to undergo a physical exam at the first sign of any symptoms of a pilonidal cyst.