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Pilonidal sinus: Treatment, symptoms, advice and help

About pilonidal sinus

A pilonidal sinus is small “hole” or “tunnel”, containing hair, which develops in the skin between buttocks (the natal cleft), slightly above the anus. The infection of this sinus by bacteria results into pain, swelling and formation of pus in the sinus tract.

Pilonidal sinus: Incidence, age and sex

Pilonidal sinus is encountered more commonly in men than in women and especially in young adults between 18-25 years of age. It is rare in children and in people over the age of 40.

Signs and symptoms of pilonidal sinus: Diagnosis

Generally, there will be no symptoms of pilonidal sinus until it gets infected. It may appear as a small pit or depression on the surface of the skin. When infected, it may cause swelling, pain, redness of the skin of the affected area. This may be accompanied with fever and filthy- bloody discharge from the infected sinus.

Pilonidal sinus is diagnosed by a doctor on the basis of symptoms and physical examination of the affected area. Blood test or other investigative procedures are generally not required.

Causes and prevention of pilonidal sinus

The exact cause for the development of pilonidal sinus is not known. However, both environmental and genetic factors play significant role in the development of pilonidal sinus. At present, the known risk factors for pilonidal sinus include obesity, large amount of body hair, family history of pilonidal sinus, poor hygiene and sedentary lifestyle.

One must maintain optimum weight and proper hygiene to prevent development and recurrence of pilonidal sinus. The area should be kept clean, dry and free of hair accumulation.

Pilonidal sinus: Complications

The complications of pilonidal sinus are mainly due to bacterial infection and include abscess formation, recurrent inflammation and recurrence of sinus formation. Rarely, the lesion may develop cancerous changes.

Pilonidal sinus: Treatment

Generally people with asymptomatic sinus are advised to keep the area clean and dry. In case of infection, the infected sinus needs to be opened to drain away pus and hair through an operative procedure known as incision and drainage. This procedure is normally carried out in the hospital and is performed under general anesthesia. Medicines are given to control pain and promote proper healing of the wound. In case of recurring infection, surgical intervention is preferred. The most commonly adopted surgery includes wide excision and primary closure. The surgical procedure is decided after understanding the relevant benefits and risks and the size and extent of the sinus. Proper wound care plays a significant role in healing and preventing recurrence. It is very important to follow post-operative wound care instructions and maintain proper hygiene for best outcome of the surgery.