Pilonidal Dimple

A pilonidal dimple, also known as a pilonidal sinus or pilonidal cyst, is a small hole or tunnel in the skin at the bottom of the tailbone (coccyx), near the crease of the buttocks. It is usually located near the midline of the body and can be a congenital condition, meaning present at birth, or acquired later in life.

Causes

The exact cause of pilonidal dimples is not fully understood, but several factors are thought to contribute to their development. These include:

• Genetics: Some people may be born with a predisposition to develop a pilonidal dimple.
• Hair growth: Hair can penetrate the skin and create a tunnel or pit, which can become infected and form a cyst or abscess.
• Trauma: Injury to the area, such as from a fall or surgery, can cause a pilonidal dimple to form.
• Friction and pressure: Repeated friction and pressure on the skin, such as from sitting or tight clothing, can contribute to the development of a pilonidal dimple.

Symptoms

Pilonidal dimples may not always cause symptoms, but when they do, they can include:

• Pain or tenderness in the affected area
• Redness and swelling around the dimple
• Pus or discharge from the dimple
• Foul odor from the affected area
• Itching or burning sensation around the dimple

Diagnosis

A pilonidal dimple is typically diagnosed through a physical examination and medical history. The doctor may:

• Visually examine the affected area to look for signs of infection, such as redness, swelling, or pus.
• Ask questions about symptoms, such as pain or discharge.
• Perform a digital rectal examination (DRE) to check for any abnormalities in the rectum or anus.

Treatment

Treatment for pilonidal dimples depends on the severity of the condition and may include:

• Antibiotics: To treat any underlying infection.
• Drainage: To remove any pus or fluid that has accumulated in the dimple.
• Surgery: To remove the pilonidal dimple and any infected tissue. There are several surgical options, including incision and drainage, excision, and pit-picking.
• Wound care: To promote healing and prevent infection after surgery.

Prevention

To reduce the risk of developing a pilonidal dimple or to prevent recurrence, it is recommended to:

• Maintain good hygiene and keep the area clean and dry.
• Avoid tight clothing that can cause friction and pressure on the skin.
• Avoid sitting for long periods of time.
• Keep the area free of hair to reduce the risk of ingrown hairs and infection.