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Pilonidal Sinus: Causes, Symptoms, Complications & Treatment

Pilonidal sinus is a small hole or tunnel in the skin, which develops in the cleft at the top of the buttocks. It is filled with pus or fluid leading to the formation of a cyst or abscess. This cyst usually contains dirt, hair, and debris, causing severe pain and can at times become infected and can ooze pus and blood, and have a foul odour. Usually, men and young adults are often affected with this condition.

What Causes Pilonidal Sinus? [1]

The exact cause of pilonidal sinus is unknown, however, the causes have been pinned down to to be a combination of changing hormone levels, hair growth, and friction from clothes or sitting for longer periods.

Friction from clothes or sitting can force the hair growing in the area to grow back under the skin. The body finds this hair to be foreign and triggers an immune response against it. The immune response then forms a cyst around the hair in that particular area.

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Symptoms of Pilonidal Sinus

The most obvious symptom is a small, dimple-like depression on the surface of the skin. Once it develops into a cyst and becomes infected, the symptoms start showing which includes swelling, pain when sitting or standing, sore skin around the area, pus or blood draining from the cyst, and hair coming out from the lesion.

Complications Associated With Pilonidal Sinus [2]

  • Severe pain
  • Inflamed, swollen skin
  • Blood and pus coming out from the cyst
  • A foul odour from the wound
  • A temperature of 100.4 degree Fahrenheit or higher

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Treatment Of Pilonidal Sinus [3]

The treatment for pilonidal sinus will depend on the symptoms, the size of the sinus, and whether it's recurrent or not.

  • Antibiotics

If you aren't experiencing severe pain, and there's no sign of inflammation, your doctor will prescribe a broad-spectrum antibiotic. A broad-spectrum antibiotic treats different kinds of bacteria. however, the antibiotics will not heal the sinus tract, but will help provide you relief from the infection and discomfort.

  • Lancing

This procedure help reduce the symptoms and lower the collection of pus inside the sinus. The doctor may give a local anaesthesia before this procedureand then will use a scalpel to open the cyst and clean the pus, blood, and hair from inside. Then, the wound will be dressed with sterile dressing and allow it to heal from inside out, which usually takes about 4 weeks.

  • Phenol injection

For this treatment, a local anaesthesia is given. Then thephenol, a chemical compound used as an antiseptic, is injected into the cyst. This treatment procedure will be repeated for several times, causing the lesion to harden and close.

  • Surgery

If the pilonidal sinus is recurring or if you have more than one, a surgical procedure is recommended. A local anaesthesia is given after which the surgeon opens the lesions, removing all the pus, hair, and debris. Then, the the wounds are sticthed and dressed.

Can Pilonidal Sinus Be Prevented?

It can be prevented by washing the area with a mild soap daily. Keep the area dry and avoid sitting for longer periods.

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View Article References
  1. [1] Bendewald, F. P., & Cima, R. R. (2007). Pilonidal disease.Clinics in colon and rectal surgery,20(2), 86–95.
  2. [2] Onder, A., Girgin, S., Kapan, M., Toker, M., Arikanoglu, Z., Palanci, Y., & Bac, B. (2012). Pilonidal sinus disease: risk factors for postoperative complications and recurrence.International surgery,97(3), 224–229.
  3. [3] Rao, J., Deora, H., & Mandia, R. (2015). A Retrospective Study of 40 Cases of Pilonidal Sinus with Excision of Tract and Z-plasty as Treatment of Choice for Both Primary and Recurrent Cases.The Indian journal of surgery,77(Suppl 2), 691–693.

Story first published: Tuesday, July 23, 2019, 12:30 [IST]
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