Pilonidal Sinus

A pilonidal sinus is a small hole or tunnel in the skin at the bottom of the tailbone (coccyx), near the crease between the buttocks. It can become infected and filled with pus, leading to a painful abscess.

Causes and Risk Factors

The exact cause of pilonidal sinus is not known, but several factors are thought to contribute to its development:

• Hair growth: Embedded hair in the skin may irritate and cause inflammation, leading to a pilonidal sinus.
• Friction and pressure: Repeated friction and pressure on the skin, such as from sitting or tight clothing, can cause a pilonidal sinus to form.
• Genetics: Family history may play a role in the development of pilonidal sinus.
• Obesity: Excess weight can increase the risk of developing a pilonidal sinus due to increased friction and pressure on the skin.

Symptoms

The symptoms of a pilonidal sinus may include:

• Pain or tenderness in the affected area, especially when sitting or standing.
• Redness and swelling around the sinus.
• Pus or discharge from the sinus.
• Foul odor from the pus or discharge.
• Fever, if the sinus becomes infected.

Diagnosis

A pilonidal sinus is typically diagnosed based on a physical examination and medical history. The doctor may:

• Examine the affected area to look for signs of infection or inflammation.
• Ask about symptoms, such as pain or discharge.
• Check for any other conditions that may be causing similar symptoms.

Treatment

Treatment for a pilonidal sinus depends on the severity of the condition:

• Conservative treatment: For mild cases, treatment may involve keeping the area clean and dry, using antibiotics to prevent infection, and avoiding activities that irritate the area.
• Incision and drainage: If the sinus becomes infected and forms an abscess, a doctor may need to drain the pus through a small incision.
• Surgery: In some cases, surgery may be necessary to remove the pilonidal sinus and any infected tissue. There are several surgical techniques that can be used, including excision with primary closure, marsupialization, and cleft lift procedure.

Complications

If left untreated, a pilonidal sinus can lead to complications such as:

• Chronic infection: The sinus can become a chronic source of infection, leading to recurring abscesses and scarring.
• Abscess formation: The sinus can become infected and form an abscess, which can be painful and require drainage.
• Scarring: Repeated infections and surgeries can lead to significant scarring in the affected area.

Prevention

To reduce the risk of developing a pilonidal sinus:

• Maintain good hygiene: Keep the area clean and dry, especially after exercise or activities that cause sweating.
• Avoid tight clothing: Wear loose, comfortable clothing to reduce friction and pressure on the skin.
• Stay at a healthy weight: Excess weight can increase the risk of developing a pilonidal sinus.