Pilonidal Sinus - Symptoms, Risk factors and Treatment

A pilonidal sinus is a small hole that can lead to the formation of a pilonidal cyst- a cavity filled with pus, hair, and debris. It occurs at the top of the cleft of the buttocks leading to infection and abscess. If left untreated, it can become severely painful. Pilonidal cyst mostly occurs in men who sit for a long time, like cab drivers who sit for a long time in the same posture. 

Symptoms

Initially, you may feel like a dimple in the skin. It may not be that painful and may not cause bothersome symptoms. But once it becomes infected, it becomes painful and oozes out pus and fluid. An infected pilonidal cyst can cause the following signs and symptoms.

• Pain while standing or sitting 
• Swelling of the cyst
• Sore skin and swelling around the area
• Pus, fluid, or blood draining from the abscess, causing a foul odor
• Hair protruding from the lesion
• Formation of more than one sinus tract, or holes in the skin
• A pilonidal cyst can also cause a low-grade fever.

Causes 

The exact cause of pilonidal sinus is unknown. However, it may occur due to friction of clothes or sweat. It is common in people who sit in the same position for long hours. According to experts, it may occur due to changing hormones because it usually occurs when puberty hits.

Sitting for a long time leads to friction, due to which the hair growing at the back burrow under the skin. Your body perceives it as a foreign particle and activates the immune system that causes inflammation and forms a cyst around it. You may have more than one cyst under the skin that connects with each other. 

Risk factors

The risk factors for pilonidal cyst can be 

• Male gender 
• Obesity 
• Inactive lifestyle
• Stiff or coarse hair
• Excess body hair 
• Sitting for a long time
• Younger age- mostly people in the age of 20s

Prevention 

To prevent pilonidal cyst you must;

• Avoid prolonged sitting. 
• Try to take breaks in between and walk. 
• Lose weight if you're obese.
• Make sure you are in the healthy range according to the body mass index.
• Keep the area clean and shower daily. 

Treatment 

For treatment, your healthcare provider may prescribe conservative treatment that is an antibiotic course. It will help get rid of the infection, but it would not fill out the sinus. It will remain open, and you may get its reinfection. 

Another treatment of pilonidal sinus involves lancing. It is a procedure in which the healthcare providers administer local anesthetic at the site and remove the abscess through surgical instruments. 

They may also administer phenol injection to fill the injection site. It may also require local anesthesia at the cyst side. 

If you have more than one cysts growing inside the skin, your doctor may advise a surgery in which they can remove all of them. 

Conclusion 

A pilonidal sinus is a small hole that can lead to the formation of pilonidal cyst- sinus filled with pus, hair, and debris. It occurs at the top of the cleft of the buttocks leading to infection and abscess. If left untreated, it can become severely painful. Initially, you may feel like a dimple in the skin. It may not be that painful and may not cause bothersome symptoms. But once it becomes infected, it causes pain and oozes out pus and fluid.