Pilonidal disease, medically known as pilonidal sinus, is a condition where one or more small tunnels or cavities form under the skin, typically in the cleft between the buttocks, near the tailbone (sacrococcygeal area). These cavities are usually filled with hair, skin debris, and other foreign materials. When a pilonidal sinus becomes infected, it can lead to a painful abscess, swelling, and discharge. It is more common in young adults.
What Causes Pilonidal Disease?
While the exact cause of pilonidal disease is not fully understood, several contributing factors are believed to play a role:
Hair Growth and Penetration into the Skin:
The most widely accepted theory is that shed hairs accumulate on the skin surface and, due to friction or pressure (especially while sitting), penetrate the skin and travel beneath it.
Subcutaneous Hair Cysts:
Inflammation of hair follicles under the skin may lead to the formation of cysts, which can eventually develop into a pilonidal sinus.
Congenital Factors:
Some individuals may have small congenital pits in the skin (pilonidal pits) in the tailbone region that can act as entry points for hair and debris.
Hormonal Factors:
Hormonal changes during puberty may stimulate hair growth and increase the risk of developing pilonidal disease.
Obesity:
Excess weight can deepen the cleft between the buttocks and increase friction, raising the risk of pilonidal sinus formation.
Prolonged Sitting:
Sitting for long periods without movement places pressure on the tailbone area, facilitating hair penetration into the skin.
Tight and Irritating Clothing:
Tight clothes and rough fabrics can contribute to friction and make it easier for hairs to enter the skin.
Symptoms of Pilonidal Disease
Symptoms can vary depending on the presence of infection and the severity of the condition. In the early stages, there may be no noticeable signs. However, once infection develops, the following symptoms may appear:
- Pain in the Tailbone Area: Especially while sitting, moving, or touching the area.
- Swelling: A tender, painful lump may be felt near the tailbone.
- Redness: Skin in the affected area may appear red and feel warm.
- Discharge: Pus or blood may drain from the lump. The discharge may have a foul odor.
- Fever: Fever may occur in cases of advanced infection.
- Itching: The area may feel itchy.
- Small Openings (Sinus Tracts): One or more small holes on the skin surface may be visible, from which discharge can emerge.
How Is Pilonidal Disease Diagnosed?
Diagnosis is typically made by a doctor through a physical examination. The diagnostic process may involve:
- Medical History: The doctor will ask about symptoms, duration, and risk factors such as prolonged sitting or obesity.
- Physical Examination: The area near the tailbone is carefully examined for swelling, redness, discharge, and sinus tracts. The doctor may gently press on the area to assess tenderness.
- Additional Tests (If Needed): Although physical examination is usually sufficient, imaging studies (like ultrasound or MRI) or blood tests may be requested in rare cases to evaluate the extent of infection or rule out other underlying conditions.
How Is Pilonidal Disease Treated?
Note: This section will describe general treatment approaches without detailing specific surgical procedures.
Treatment depends on the presence of infection, whether the condition is acute or chronic, and the patient’s overall health. Common treatment strategies include:
- Treatment of Acute Infection: Infected pilonidal disease usually requires drainage of the abscess to relieve pressure and control the infection. This is often performed under local anesthesia through a minor surgical procedure. Antibiotics may be used to prevent the spread of infection.
- Surgical Treatment: Chronic or recurrent cases often require surgical intervention. Various surgical techniques exist, and the doctor will choose the most appropriate method based on the patient’s condition. The aim of surgery is to completely remove the sinus tracts and any embedded hairs or debris.
- Minimally Invasive Techniques: In some cases, less invasive methods (e.g., endoscopic cleaning of sinus tracts) may be considered.
Pilonidal Sinus Surgery
Note: This section will not go into detail about specific surgical techniques. The general principles and goals of surgery will be discussed.
Surgery for pilonidal disease generally involves excising the sinus tracts and infected tissue in the tailbone area. The main goals of surgery are:
- Complete Removal of Sinus Tracts and Cysts: Removing all the cavities and contents responsible for the pilonidal disease helps reduce the risk of recurrence.
- Promote Healthy Tissue Healing: Proper post-operative care aims to ensure the area heals completely and healthily.
Depending on the procedure and the patient’s condition, surgery may be performed under local, spinal, or general anesthesia. Post-operative wound care, pain management, and adherence to medical advice are crucial. Recovery time varies depending on the surgical method used.
How Can Pilonidal Disease Be Prevented?
Some measures that can help reduce the risk of developing pilonidal disease include:
- Good Hygiene: Keeping the tailbone area clean and dry is essential. Regular washing and thorough drying can prevent the accumulation of hair and skin debris.
- Hair Control: Shaving or reducing hair growth in the tailbone region (e.g., with laser hair removal) may help prevent hair from penetrating the skin.
- Comfortable Clothing: Avoid tight, abrasive clothing. Opt for looser, cotton-based underwear.
- Avoid Prolonged Sitting: Minimize long periods of sitting without movement. Take regular breaks to stand and walk, especially during long trips or desk work.
- Healthy Weight: Maintaining a healthy weight can help reduce the depth of the buttock cleft and minimize friction.
Does Pilonidal Disease Go Away on Its Own?
Pilonidal disease typically does not resolve on its own, especially if infection has developed. An infected sinus may form an abscess that requires treatment. In mild, non-infected cases, good hygiene and hair control may alleviate symptoms. However, sinus tracts usually persist and pose a risk of recurrence. Chronic or recurring cases often need medical or surgical treatment.
Frequently Asked Questions About Pilonidal Disease
Is pilonidal disease contagious?
No, pilonidal disease is not contagious.
Can pilonidal disease turn into cancer?
Pilonidal disease does not usually turn into cancer. However, in rare cases of long-standing, untreated chronic disease, squamous cell carcinoma (a type of skin cancer) has been reported. Therefore, proper monitoring and treatment of chronic pilonidal disease are important.
Which doctor should I see for pilonidal disease?
Individuals experiencing symptoms of pilonidal disease should consult a general surgeon.
Is non-surgical treatment possible for pilonidal disease?
In early-stage or small, non-infected cases, minimal intervention or hygiene and hair control may help manage the condition. However, chronic or infected cases generally require surgical treatment.
How long does recovery take after pilonidal surgery?
Recovery time varies depending on the surgical technique used, the size of the wound, and the patient’s general health. Open surgeries may take several weeks to heal, while recovery can be faster with some closed techniques.
All content on this site is for informational purposes only and is based on scientific resources available at the time of publication. For any symptoms, diagnosis, or treatment related to health, please consult your physician or a licensed healthcare provider directly.