Pilonidal Sinus

What is a Pilonidal Sinus and Pilonidal Cyst?

A pilonidal sinus (PNS) is a small hole or tunnel in the skin that can fill with fluid or pus, potentially forming a cyst or abscess. It typically occurs in the cleft at the top of the buttocks. A pilonidal cyst usually contains hair, dirt, and debris.

This condition primarily affects men and is particularly common among young adults and individuals with sedentary lifestyles, such as taxi drivers.

Common Signs and Symptoms

Initially, you may not notice any symptoms beyond a small, dimple-like depression on the skin’s surface. However, if the depression becomes infected, it can quickly develop into a cyst (a closed sac filled with fluid) or an abscess (inflamed tissue filled with pus).

Signs of infection include:

  • Pain when sitting or standing
  • Swelling of the cyst
  • Reddened, sore skin around the area
  • Pus or blood draining from the abscess, accompanied by a foul odour
  • Hair protruding from the lesion
  • Formation of multiple sinus tracts or holes in the skin
  • Low-grade fever (less common)

Causes of Pilonidal Sinus

Pilonidal cysts are caused by groups of hairs and debris trapped in the skin pores in the upper cleft of the buttocks, leading to an abscess. Risk factors include:

  • Being male
  • Sedentary lifestyle
  • Thick body hair
  • Family history
  • Being overweight
  • Previous pilonidal cysts

Pilonidal Sinus Treatment

Treatment for an infected pilonidal sinus depends on your symptoms, the size of the sinus, and whether it is your first occurrence or a recurring issue. Generally, treatment options for pilonidal sinus include:

  1. Incision & Drainage: A small incision is made in the abscess to drain the pus.
  2. Excision and Open Healing: The sinus is excised, and the surrounding skin is removed; the wound is left open to heal naturally.
  3. Excision and Wound Closure: The sinus is removed, and an oval-shaped flap of skin is cut out on either side; the sides are stitched together.
  4. Endoscopic Treatment for Pilonidal Sinus (EPSIT) with Laser: This is a minimally invasive technique that uses an endoscope to visualise the affected area. Hair and infected tissue are removed, and the sinus is cleaned. Heat or laser is then applied to seal the sinus.

Recovery Period

Recovery time varies depending on the procedure performed. Most people can return to work within a few days. It is essential to keep the affected area clean, wear comfortable, loose-fitting cotton underwear, consume plenty of fibre to ease bowel movements and avoid straining. You may also require antibiotics and pain relief medication.

For more information or to schedule a consultation with Dr. Mouhsen Al Hosein, contact today.

FAQs

How is a pilonidal sinus diagnosed?

Diagnosis typically involves a physical examination by your doctor, who will assess the area for signs of infection or abscess.

Can pilonidal sinuses recur after treatment?

Yes, pilonidal sinuses can recur, especially if not completely excised. EPSIT has a lower recurrence rate compared to traditional methods.

Are there any home remedies for pilonidal sinus?

While home remedies may provide temporary relief, it is essential to consult a healthcare professional for effective treatment.

What lifestyle changes can help prevent pilonidal sinus?

Maintaining good hygiene, avoiding prolonged sitting, and managing body hair can help reduce the risk of pilonidal sinus development.

Is pilonidal sinus surgery painful?

Most patients experience some discomfort post-surgery, but pain can be managed effectively with medication.

How long is the recovery time after pilonidal sinus surgery?

Recovery time varies based on the procedure, but many patients return to normal activities within a few days.

Will I need to change my diet after surgery?

Yes, a high-fibre diet is often recommended to prevent constipation and promote healing during recovery.

What should I do if I suspect I have a pilonidal sinus?

If you notice symptoms such as pain or drainage from the area, consult a healthcare professional for an accurate diagnosis and treatment options.

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