What is the definition of Pilonidal Sinus Disease?

Pilonidal sinus disease is an inflammatory condition involving the hair follicles that can occur anywhere along the crease between the buttocks, which runs from the bone at the bottom of the spine (sacrum) to the anus. The disease is benign and has no association with cancer.

Pilonidal dimple may appear as:

  • A pilonidal abscess, in which the hair follicle becomes infected and pus collects in the fat tissue
  • A pilonidal cyst, in which a cyst or hole forms if there has been an abscess for a long time
  • A pilonidal sinus, in which a tract grows under the skin or deeper from the hair follicle
  • A small pit or pore in the skin that contains dark spots or hair

What are the alternative names for Pilonidal Sinus Disease?

Pilonidal abscess; Pilonidal sinus; Pilonidal cyst; Pilonidal disease

CONSIDERATIONS

Symptoms may include:

  • Pus draining to a small pit in the skin
  • Tenderness over the area after you are active or sit for a period of time
  • Warm, tender, swollen area near the tailbone
  • Fever (rare)

There may be no symptoms other than a small dent (pit) in the skin in the crease between the buttocks.

What are the causes for Pilonidal Sinus Disease?

The cause of pilonidal disease is not clear. It is thought to be caused by hair growing into the skin in the crease between the buttocks.

This problem is more likely to occur in people who:

  • Are obese
  • Experience trauma or irritation in the area
  • Have excess body hair, particularly coarse, curly hair

HOME CARE

Wash normally and pat dry. Use a soft bristle scrub brush to prevent the hairs from becoming ingrown. Keep the hairs in this region short (shaving, laser, depilatory) which may decrease the risk of flare-ups and recurrence.

When should I contact a medical professional for Pilonidal Sinus Disease?

Call your health care provider if you notice any of the following around the pilonidal cyst:

  • Drainage of pus
  • Redness
  • Swelling
  • Tenderness

WHAT TO EXPECT AT YOUR OFFICE VISIT

You will be asked for your medical history and given a physical examination. Sometimes you may be asked for the following information:

  • Has there been any change in the appearance of the pilonidal sinus disease?
  • Has there been any drainage from the area?
  • Do you have any other symptoms?

Pilonidal disease that causes no symptoms does not need to be treated.

A pilonidal abscess may be opened, drained, and packed with gauze. Antibiotics may be used if there is an infection spreading in the skin or you also have another, more severe illness.

Other surgeries that may be needed include:

  • Removal (excision) of the diseased area
  • Skin grafts
  • Flap operation following excision
  • Surgery to remove an abscess that returns
Anatomical
Pilonidal

REFERENCES

Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Surgical conditions of the anus and rectum. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 371.

Sell NM, Francone TD. Management of pilonidal disease. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:335-341.

Surrell JA. Pilonidal cyst and abscess: current management. In: Fowler GC, ed. Pfenninger and Fowler's Procedures for Primary Care. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 31.

  • Condition: Pilonidal Sinus Disease (PSD)
  • Journal: Chirurgia (Bucharest, Romania : 1990)
  • Treatment Used: Silver Nitrate Application as Mini-Invasive Treatment
  • Number of Patients: 11
  • Published —
This study investigated the cure rate and adverse effects of silver nitrate application for treatment of pilonidal sinus disease (PSD).
  • Condition: Pilonidal Sinus Disease
  • Journal: Rozhledy v chirurgii : mesicnik Ceskoslovenske chirurgicke spolecnosti
  • Treatment Used: Karydakis flap, Bascom cleft lift, and Limberg Flap Procedures
  • Number of Patients: 27
  • Published —
The study researched the treatment methods for Pilonidal sinus disease.
Clinical Trial
  • Status: Recruiting
  • Phase: N/A
  • Intervention Type: Procedure
  • Participants: 30
  • Start Date: June 12, 2020
Lay Open and Curettage Versus Endoscopic (E.P.Si.T) Method in the Treatment of Sacrococcygeal Pilonidal Sinus Disease
Clinical Trial
  • Status: Recruiting
  • Phase: Phase 4
  • Intervention Type: Drug
  • Participants: 140
  • Start Date: June 3, 2020
Comparison of Phenol and Silver Nitrate Application in the Sacrococcygeal Pilonidal Sinus: A Prospective Randomized Controlled Study