Pilonidal sinus

Pilonidal sinus

Last Updated November 2nd, 2022

An open pilonidal sinus can drain and close on its own.
Pilonidal sinus is rarely fatal. But there are rare cases of squamous cell carcinoma in cases of untreated recurrent pilonidal sinus disease.
Yes, doctors advise regular hair removal in the natal cleft region to prevent recurrence of pilonidal sinus. Patients can shave, use hair removing creams, or remove hair by laser.

What is a pilonidal sinus?

A pilonidal sinus (PNS) is a small sinus tract or tunnel under the skin in the natal cleft between the buttocks. A pilonidal sinus may contain hair, debris, and get infected. An infected PNS may leak pus or blood. It may be red, inflamed, painful, and have a foul smell.

A pilonidal sinus may be asymptomatic. Treatment is needed once it is infected and causes discomfort. PNS is more common in young adults and men.

What causes pilonidal sinus?

Causes for pilonidal sinusThe exact reason for pilonidal sinus is unknown. Here are a few possible causes:

  • Hormonal changes causing hair growth in the pilonidal sinus.
  • Prolonged sitting causes friction and force hair to grow inwards (ingrown hair) rather than outwards. The body may react to the ingrown hair and develop a cyst around the hair.
  • Men are hairier than women and develop the condition.
  • Some people are born with minor skin deformities where the hair grows inward in the buttock region than outwards.
  • Some people have skin dimples in the buttocks. Pressure or friction may force the hair growing in the natal clefts to push towards the skin dimples.
  • Hair fragments in the skin cause inflammation and infections.
  • Pressure or injury to the natal cleft.
  • Lack of hygiene.
  • Having less than 2 baths in a week.

Who are at risk of developing pilonidal sinus?

  • Being male.
  • Overweight.
  • Coarse or rough hair.
  • Young men in their 20s.
  • Sedentary lifestyle.
  • A lot of body hair.
  • Sedentary occupation.
  • Deep or hairy natal cleft.
  • Family history of pilonidal sinus.
  • Buttock shape and curvature.

What are the symptoms?

Pilonidal sinus symptomsIn the beginning, a pilonidal sinus may not show any symptoms. You may notice a small painless bulge or lump near the buttock region while washing or bathing. Symptoms develop gradually and within a few days, you may notice some pain, swelling, and pus discharge.

Signs of infection:

  • Swelling.
  • Pain.
  • Redness.
  • Foul odor.
  • Pus discharge.
  • Bleeding.
  • Hair protruding from the pilonidal sinus.
  • Formation of one or multiple sinus tracts.
  • Low fever.

Treatments for pilonidal sinus

Medications

For mild symptoms and minimal pain, doctors prescribe broad-spectrum antibiotic medications. The medications cannot heal the sinus completely but provide relief from pain and discomfort. Doctors also prescribe anti-inflammatory medications and paracetamols for inflammation and pain. Besides medications, patients must shave and keep the area clean and follow up with the doctor regarding progress and treatment plan.

Phenol injection

The doctor applies a local anesthetic that numbs the area. The doctor then injects a chemical substance called phenol into the lesion. This treatment is repeated several times until the lesion hardens and closes. This treatment is very popular and has a high success rate.

Surgery

Doctors recommend surgery especially if you have recurring, infected, and multiple pilonidal sinuses. The procedures are mostly done under local anesthesia. The surgeons open the lesions and remove pus, debris, and hair. The wounds are stitched and dressings are applied. After healing, patients must shave and clean the area to prevent further hair growth.

Diagnosis

Your healthcare provider will do a physical examination. The pilonidal sinus will be easy to detect. The doctor will check for any infections, pus, redness, or inflammation. The healthcare provider will need information regarding:

  • The symptoms.
  • Changes in the symptoms.
  • Any drainage or bleeding.
  • Pain.
  • Is the sinus tract recurring in nature?
  • Other skin issues.

An MRI or CT scan may be ordered to check the sinus tract.

Procedures

Lancing

Doctors perform this procedure when there is pus formation or an abscess. It is done under a local anesthetic. The doctor makes a small cut with a scalpel to open the abscess. Any pus, blood, or hair is removed and the area is cleaned. The doctor then packs the wound with a sterile dressing. The wound generally heals in four weeks.

Marsupialization  

Here, the doctor makes a small cut, drains the sinus, and removes pus, hair, and blood. The open edges are sewed to form a pouch. The procedure is easy and only a small cut is needed. Healing normally takes 6 weeks.

Wide excision with secondary intention healing

The doctor cuts the sinus (excision) along with a wide portion of the surrounding skin. The wound site is not closed but left open and allowed to heal by itself (healing by secondary intention). The doctor removes the surrounding inflamed tissues reducing the chances of recurrence. Healing takes several weeks. During this time, the patient must regularly change the dressings.

Excision with primary closure

The healthcare provider cuts oval-type (ellipse) flaps of skin on either side of the sinus. The sinus is taken out. The ellipses are stitched back. Healing is faster in this procedure, however, there is a risk of recurrence.

Plastic surgery

Sometimes, the sinus is recurrent and covers a wide range of the skin. This may leave scarring. Doctors advise removal of the sinus along with plastic surgery to remodel the skin.

Endoscopic ablation

The procedure is done with local or spinal anesthetic. The doctor inserts an endoscope with a camera at the end to get a clear view of the sinus tract. The tissues and debris are removed and the area is cleaned with a special solution. The wound site is sealed with heat. It is a less invasive procedure with minimal complications.

Post-surgery care

Follow instructions regarding rest, home care, and wound dressing.

  • Keep the incision site clean.
  • Check if the incision site is healing properly.
  • See if there are any infections.
  • Go for follow-up visits.
  • See if there is any recurrence of the disease.
  • Take proper rest and allow the wound to heal completely.

Prevention

Pilonidal sinusMaintain good hygiene. This is the only way to prevent or avoid the recurrence of the disease.

  • Keep the area clean.
  • Shave the area or use depilatory creams to remove hair.
  • If you are obese, lose weight.
  • Wash the buttocks region regularly.
  • Do not sit for too long. Do not put too much pressure on the buttock region.

Is pilonidal sinus fatal?

No, pilonidal sinus is not fatal. But long-term untreated pilonidal sinus can have several health problems. Recurrent pilonidal sinus can lead to chronic pilonidal disease. If untreated, the infection can spread to other body parts and become fatal. In very rare cases, there is a risk for squamous cell carcinoma (SCC).

 

An open pilonidal sinus can drain and close on its own.
Pilonidal sinus is rarely fatal. But there are rare cases of squamous cell carcinoma in cases of untreated recurrent pilonidal sinus disease.
Yes, doctors advise regular hair removal in the natal cleft region to prevent recurrence of pilonidal sinus. Patients can shave, use hair removing creams, or remove hair by laser.

 

Dos and Don'ts

Dos
  • Good hygiene.
  • Shave the area regularly.
  • Lose weight.
Don'ts
  • Ignore symptoms.
  • Wear tight clothes.
  • Squeeze or pierce the lesion on your own.

 

 

 

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9 benefits of walking we bet you didn’t know! Did you know walking can be the miracle pill for eternal youth? Everyone knows walking is good for…
Dragon Fruit – Blessing from Nature’s Basket Dragon fruit is packed with nutrients but low on calories. It is the dream food that can help…
How can berberine supplements help you live longer and healthier? Berberine is a turmeric look-alike herbal extract that is credited with numerous health benefits ranging from diabetes cure…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
Experts reveal the safest ways to perform an enema at home The idea of pushing some up your rectal area might make you queasy but an enema could actually…
What is the right way to take a pregnancy test? A pregnancy test is undertaken to determine if you have conceived. A home pregnancy test is the most…
GERD heartburn
Heartburn: What are the exact symptoms and the best home remedies? There are easy home remedies for heartburn, which not only acts as a first aid when you experience…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
blood elements analysis
Blood Element Analysis Test A blood element analysis is a blood test performed to measure the level of toxic elements such as…
fructosamine test
Fructosamine Test A fructosamine test measures blood sugar glucose content. Fructosamine level can indicate blood sugar level in past 2-3…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
iron deficiency profile
Iron Deficiency Profile An iron deficiency profile is a battery of blood tests which are performed in order to determine the…
Diabetes blood test
Diabetic Profile The diabetic profile is a set of tests used for testing and monitoring the various kinds of Diabetes…
oral hygiene tips
6 shocking consequences of bad oral hygiene (and how to avoid them) Did you know bad breath is not just turning off, but also harms your body in ways you…
xylitol gum
Xylitol : Is this the right sugar substitute for you? Discovered during World War 2 owing to sugar shortage, xylitol has become a common name in pharamaceutical industry.…
avocado benefits
Avocado: 15 reasons why this fruit should be a staple in your diet Did you know that the word avocado literally means "testicles". Don't get grossed out as this power-packed fruit…
ashwagandha brain
Ashwagandha: The best-kept secret of Ayurveda now revealed! Ashwagandha literally means "smell of horse". Don't get bogged down by that one tiny detail because this ayurveduic…
black seed oil benefits
Black Seed Oil: What secret benefits could it bestow on your health? Black seeds or nigella seeds are tiny packets of health brimming with amazing benefits. Find out why should…
Cayenne: The remarkable benefits of these red hot chili peppers These may make you rush for a glass of water, but cayenne pepper is actually a healthy additive…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
Mood swings
The real reasons for your mood swings and how to overcome them Are you prone to heated moods frequently? Do you also feel bouts of depressive feeling creeping up on…
glucose-tolerance
Oral Glucose Tolerance Test – GTT Glucose tolerance test (or Oral GTT) is used to detect the onset of diabetes or prediabetes conditions. It…
ASTtest-liver
AST- Aspartate Aminotransferase Test AST test is a blood test that is used to measure the level of a particular liver enzyme…
ANTIPHOSPHOLIPIDANTIBODY(APL)_IgG
Antiphospholipid (APL) antibody-IgG The Antiphospholipid Antibody testing is a blood test used to determine an autoimmune disorder called Antiphospholipid syndrome linked…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
malarial antigen test
Malaria Antigen Test A malaria antigen test is a rapid diagnostic test (RDT) that can detect malarial antigens (proteins) in your…
Hepatitis A virus infected liver
Hepatitis A Virus (HAV) Total Blood test to look for IgM antibodies to know if you are infected with Hepatitis A virus (HAV),…
stress depressed anxiety
Are you depressed or just stressed? Know when to see a doctor Why are some people more anxious than others? Is being depressed the same as feeling sad? Have you…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…
L-theanine attention
L-Theanine: Better sleep, higher focus, and many other benefits Did you know that L-theanine found in green tea can make you sleep better and be focused at…
aspartame or sugar
Aspartame – Hidden truths about this storm in a teacup Aspartame, the artificial sweetener, has gone under the scanner on several occasions for allegedly doing more harm than…
High Fiber Diet – Fire up your fiber intake for these health benefits! Regular bowels, healthy detox, higher immunity, and guaranteed weight loss - a high fiber diet can bring all…
gallbladder diet tomato
Gallbladder surgery :Tips on post-operative care and diet What to eat post a gallbladder surgery? What are the key things to avoid if you had a…
Agave nectar: The bitter truth about this sweetener revealed Agave nectar is considered to be sweeter than the normal table sugar and even contains higher amounts of…
DHEA wrinkles
DHEA: Now get unbelievable age defiance with this wonder hormone! DHEA is known popularly as the age-defying hormone. This supplement is widely used to slow down aging and…
Oil of Oregano: The one-stop essential oil you’ve been looking for Are you plagued by a weak immune system? High body inflammation accompanied by pain and infections? Why not…
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…
How seitan proved to be a blessing in disguise for vegans worldwide Can only meat-eaters enjoy delicious juicy steaks and burgers? With seitan, the best meat substitute available today,even vegans…
How can Kegels help you overcome weak pelvic muscles & incontinence? Kegel exercises are pelvic floor strengthening exercises that can help you overcome incontinence issues that rise out of…
Pescatarian Diet 101: What are the inherent health advantages of this diet? People opt to become a pescatarian in order to enrich their bodies with the essential health benefits that…
shakeology woman
Meal replacement or protein drink? Learn all about Shakeology and its claims Shakeology from Beachbody claims to be the most suitable shake that can aid in weight loss, regulate blood…
Inhale oxygen, exhale worries: The top breathing exercises and how to perform them Performing the breathing exercise is like becoming mindful of how you breathe.  Here is a list of breathing…
hemoglobin variant analysis
Hemoglobin Variant Analysis Hemoglobin variant analysis is a blood test that is used to detect the presence of hemoglobin variants which…
cystatin C
Cystatin C Test Cystatin C is a specific single-chain protein that is found in body fluids and is a biomarker for…
piles fissure fistula
Allopathy vs homeopathy vs ayurveda treatment for piles, fissures, and fistula Read to know the best form of treatment among allopathy, homeopathy,or ayurveda for piles, fissures, and fistula
liver detox facts
7 liver detox facts and why ignoring these could kill you! Are you taking care of this organ that handles over 500 different vital functions in your body? Your…

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