Is Pilonidal Sinus Disease (PNS)?
A pilonidal sinus (PNS) is a small cyst or abscess that
occurs in the cleft at the top of the buttocks. A PNS usually contains hair, dirt,
and debris. It can cause severe pain and can often become infected. If it
becomes infected, it may ooze pus and blood and have a foul odor.
A PNS is a condition that mostly affects
men and is also common in young adults. It’s also more common in people who sit
a lot, like cab drivers.
Are the Causes of Pilonidal Sinus Disease?
The exact cause of this condition is not known, but its cause is
believed to be a combination of changing hormones (because it occurs after
puberty), hair growth, and friction from clothes or from spending a long time
Activities that cause friction, like sitting, can
force the hair growing in the area to burrow back under the skin. The body considers this hair foreign and
launches an immune response against it, similar to how it would react when
dealing with a splinter. This immune response forms the cyst around your hair.
a Pilonidal Sinus and Recognizing Signs of Infection
You may not have any noticeable symptoms at first other than a
small, dimple-like depression on the surface of your skin. However, once the
depression becomes infected, it will quickly develop into a cyst (a closed sac
filled with fluid) or an abscess (a swollen and inflamed tissue where pus
The signs of an infection include:
- pain when sitting or standing
- swelling of the cyst
- reddened, sore skin around the area
- pus 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
You may also experience a low-grade fever, but this is much less
Are Pilonidal Sinuses Treated?
If your case is diagnosed early on, you aren’t experiencing
severe pain, and there’s no sign of inflammation, it’s likely that your doctor
will prescribe a broad-spectrum antibiotic, which is an antibiotic that treats
a wide range of bacteria. It’s important to realize that this won’t heal the
sinus tract, but it will give you relief from the infection and discomfort. Your
doctor will recommend that you get a follow-up exam, regularly remove hair or
shave the site, and pay particular attention to hygiene.
Before this procedure, your doctor will give you a local
anesthetic. They will then use a scalpel to open the abscess. They will clean
away any hair, blood, and pus from inside the abscess.
Your doctor will pack the wound with sterile dressing and allow
it to heal from the inside out. The wound usually heals within four weeks, and
many patients don’t require any further treatment.
For this type of treatment, your doctor will first give you a
local anesthetic. They will then inject phenol, a chemical compound used as an
antiseptic, into the cyst. This procedure may need to be repeated several
times. Eventually, this treatment will cause the lesion to harden and close.
This treatment has a very high recurrence rate. Therefore, it’s very
uncommon in the United States. Doctors turn to surgery as the treatment of choice
in some cases.
If you have a recurring PNS or if you have more than one sinus
tract, your doctor will recommend a surgical procedure.
You will first be given a local anesthetic. Then, the surgeon
will open the lesions, removing all of the pus and debris. Once this process is
complete, the surgeon will stitch the wounds closed.
After surgery, your doctor will explain how to change the
dressings and will recommend shaving the site to prevent hair from growing into
Is the Outlook for Pilonidal Sinus Disease?
Depending on the severity of the disorder and the type of
treatment, a PNS will usually clear up within four to 10 weeks.
Complications Are Associated With Pilonidal Sinus Disease?
There are a number of complications that may arise from PNS.
These include wound infection and a recurrence of the PNS even after surgery.
Signs that the wound is infected include:
- severe pain
- inflamed, swollen skin
- a temperature of 100.4°F or higher
- blood and pus seeping from the wound site
- a foul odor coming from the wound
Can I Prevent Pilonidal Sinus Disease?
You can prevent recurrence of PNS by washing the area on a daily
basis with a mild soap, making sure all soap is removed, keeping the area
completely dry, and avoiding sitting for long periods.