Pilonidal sinus

Pilonidal sinus

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).

 

Facts

Men are more prone to develop pilonidal sinus than women.

Facts

In very rare cases, pilonidal sinuses can develop into squamous cell carcinoma. Doctors will send a pus sample for confirmation.

Facts

Sometimes pilonidal sinus has no symptoms. People may only notice a lump. The lump may later develop symptoms like pain or swelling.

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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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apolipoprotein a1 test
Apolipoprotein -A1 (APO-A1) Test Apolipoprotein A-I (Apo-A1) constitutes 70% of protein content in high-density lipoprotein (HDL) and helps in lipid metabolism.
Thyroid disorders
Thyroid Profile Thyroid profile is a panel of blood tests performed to check if an individual is suffering from any…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
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),…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
lose weight fast
12 easy and instant steps to successful weight loss Do you want to lose weight without losing your mind? Does weight loss always mean saying goodbye to…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
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…
nutritional yeast bread
Nutritional Yeast : How can a fungi culture be good for your body? Nutritional yeast: How a simple culture of fungi can transform your skin, digestion, immunity , and much more.…
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…
Cottage cheese: What can you find in this healthy chunk of fresh milk cheese? Love cheese but scared of putting on extra pounds? With cottage cheese, you can get the best of…
General adaptation syndrome: Understanding stress, one step at a time The struggle of the body to produce hormones during a stressful situation is the main theme of general…
Inversion Therapy: The anti-gravity way of healing chronic back pain Inversion therapy involves suspending a person upside dow using different types of equipment. This works by taking the…
The Cabbage Soup Diet: The healthiest way to instant weight loss Cabbage soup diet rapid weight loss diet for those who want to shed those extra pounds in less…
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
Rubella IgM test
Rubella IgM Test The Rubella IgM test is a blood test that is performed to diagnose the presence of the rubella…
Unbelievable health benefits of gooseberries (and a few tasty recipes) Gooseberries are antioxidant-rich tasty fruits that can be easily added in daily diet to improve overall health and…
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
Optavia diet
The features of an Optavia diet The Optavia diet endorses pre-packaged meals and snacks called "fuelings" that are tasty, low in calorie, and incorporates…
sleep deprivation
Don’t let your sleep deficit grow into memory loss or heart attack Why is sleep important for us? How could sleep deprivation harm you? We bet you didn't know about…
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…