All about Pilonidal Sinus and its treatment
Pilonidal sinus is a condition in which a sinus forms in the left cleft of your buttocks. Pilonidal sinus may not always be accompanied by symptoms. However, it is important that you receive medical attention as soon as possible before it gets infected. An infection on a pilonidal sinus is often characterized by swelling and pain. If not treated, an abscess may also form, from which pus drains.
It is not clear yet what causes pilonidal sinus although it seems to be triggered by loose hair that finds its way into the skin around the cleft of the buttocks. The condition is exacerbated by the application of pressure and friction on the affected region. Pilonidal sinus is more common among males. This could be because men tend to have more anal hair than women. Being obese and younger may also contribute to the risk of developing pilonidal sinus.
The condition may also be hereditary. Some individuals are born with an abnormality of the skin around the sinus cleft. Whatever the cause, pilonidal sinus can be an embarrassing condition to discuss, not to mention the inflammation and irritation in the anal region. We have an able team of experts who are committed to guiding you through the journey of identifying the symptoms of pilonidal sinus and getting proper treatment.
We will also educate you on the possible risk factors so that you can take a decisive step towards avoiding these, wherever possible. The condition can be prevented by maintaining the natal cleft region clean, weight reduction, and avoiding sitting for too long.
Causes of pilonidal sinus
The actual cause of pilonidal sinus is far from clear. Several theories have emerged and they all try to explain the causes of pilonidal sinus. The first theory describes pilonidal sinus as a genetic condition. In other words, pilonidal sinus runs in families. According to this theory, a person is born with a minor abnormality whereby the hair grows into your skin, as opposed to the normal pattern of growth from inside towards the outside.
The second theory cites the development of skin pits in the cleft of your buttocks. The skin pits so developed are a result of local friction or pressure between your buttocks. Due to this friction, the hair follicles beneath your skin get damaged. As a result of local pressure, the hair between the buttocks could get pushed into the skin pits that have developed around this region. As soon as the hair fragments enter your skin pits, they get ‘stuck’, thereby causing inflammation and irritation.
Some of the risk factors of pilonidal sinus include:
- Younger age: pilonidal sinus is especially common among those below age 30. Beyond this, the risk reduces significantly
- Males: men are at a higher risk of developing pilonidal sinus than women. This is probably because they are hairier compared to women. Also, Caucasian males are predisposed to pilonidal sinus, due to their body hair which is dark and coarse.
- Obesity: being overweight is also a risk factor for pilonidal sinus as such individuals may experience excessive sweating
- Occupation: people who sit for prolonged periods of time, such as office workers and cab drivers, are also at a higher risk of developing pilonidal sinus.
Signs and symptoms of pilonidal sinus
A pilonidal sinus may not always be accompanied by symptoms. Therefore, you are likely to have the condition and not know about it. However, if you are careful while taking a bath, you may be lucky enough to notice a lump in the left cleft of your buttocks. The lump may be painless. With time, you might notice other symptoms as the condition progresses. The symptoms can be categorized as acute or chronic, depending on the rate of onset.
- Acute symptoms: The affected area gets swollen and is painful. The swelling goes on for several days. It culminates in an abscess in the skin surrounding the sinus. This acts as a clear indication of skin infection, tender to touch, and also painful
- Chronic symptoms: About 4 out of 10 people manifest persistent pilonidal sinus symptoms. The pilonidal sinus is also painful, but not as intense as it is with those suffering acute symptoms. Puz oozes from the infected sinus and this helps relieve pain to some extent.
Nonetheless, you still need to seek medical attention. The area may get inflamed, appear red in colour and also give out a foul odour. Patients experience discharge and pain for a prolonged period unless they seek treatment.
How can we diagnose pilonidal sinus?
A complete physical examination is required to diagnose a pilonidal cyst. As the medical team conducts the physical exam, they will likely check your buttocks for any signs of creases, as this could be indicative of a pilonidal cyst. Although a physical examination can feel embarrassing, there is nothing to fear. It is the only way that a diagnosis for this condition can be made. The examination involves checking for a pimple or oozing cyst. If the medical examination reveals a cyst, the patient will need to answer a number of questions such as:
- Whether there has been a change in the appearance of the cyst
- If there is any fluid draining from the cyst
- Any other symptoms
A full physical examination helps in making a proper diagnosis for pilonidal cysts. At the same time, the medical team may order an MRI or CT scan to check for sinus cavities that could have developed beneath your skin surface. This rarely happens but may be necessary in case the physical examination is not very clear.
Imaging modalities are also useful as they help rule out other diseases, besides pilonidal sinus. In this case, imaging helps to determine the level of disease progression. Methylene blue helps in determining the recurrence of Pilonidal sinuses.
Ultrasound may also be done with a view to determining the extent of the disease.
How is pilonidal sinus treated?
Treatment modalities for pilonidal sinus differ across patients. It is also determined by the clinical presentation of the condition. If the pilonidal sinus is dormant, there is no need to initiate any treatment. This is because the pilonidal sinus is immune to any infection in such a silent phase. However, care should be exercised to reduce the probability of infection.
It is important to ensure that:
- The area is maintained as dry and as clean as possible
- Do not sit for a long duration
- Use a hair removal cream or a razor to remove any hair found in this region. Our dermatologists can advise you on the benefits of laser energy to remove such hair permanently
In case the pilonidal sinus has a discharge or is painful, this is a clear sign of an infection. Consequently, there is a need to undergo a surgical procedure.
The following are some of the surgical procedures that we offer to treat pilonidal sinus:
Wide excision: The procedure involves making a wide bore on the affected skin. The surgeon leaves the ensuing cavity to facilitate healing. Once the cavity has healed, it is filled in by natural means. The wound should be dressed to avoid infection
One of the drawbacks of wide excision is that it results in a large wound. The wound may take longer to heal. It can take as long as 3 months to heal. Secondly, wound dressing is a tedious process, as this has to be done every day. On the other hand, the wide excision procedure is very safe. It has a low recurrence rate of between 10 and 15%.
Laser Pilonidoplasty: This procedure involves the use of laser energy to treat pilonidal sinus. The procedure is minimally invasive. The surgeon makes a small cut on the skin that contains the sinus tract. The surgeon drains out all the pus contained in the pilonidal sinus. This is followed by sealing the sinus tract in its entirety using laser fiber.
Benefits of laser pilonidoplasty
- The procedure is less invasive as there is minimal cutting involved
- There are no scars or wounds left after laser surgery to correct the pilonidal sinus. Therefore, the probability of postoperative complications and infections are almost nil
- The procedure takes place within 30-40 minutes. The patient can get discharged in less than 24 hours following surgery. A patient can return to the daily routine within 3-4 days after surgery
- It takes between six to eight weeks for complete healing of the wound. Therefore, laser pilonidoplasty is characterized by faster healing compared to traditional surgical procedures, such as wide excision
- Laser pilonidoplasty has a negligible recurrence rate
While conventional surgical procedures for pilonidal sinus needs regular dressing, there is no need to regularly replace dressing for surgery using a laser.
Post-op care and diet
Although laser surgery for Pilonidal sinus is less invasive, we advise you on the kind of food that you should be eating post-surgery. This will aid in quicker recovery. Our dieticians usually recommend that patients who have undergone a surgical procedure for Pilonidal sinus should consume a fiber-rich diet. Foods such as cereals and fruits are high in fiber and will help in easy bowel movement. Greasy and spicy foods should be avoided for they cause discomfort and might result in constipation.
Our surgical team will closely monitor your situation after surgery, to avoid the development of complications. Our telephone lines remain open 24/7 and you are free to give us a call any time. We also advise you on the kind of physical activities you can engage in to facilitate recovery. Certain exercises are, however, discouraged as they can exacerbate discomfort and pain.
If your job involves sitting a lot, you could be at risk of pilonidal cyst. It usually develops at the bottom of your tailbone. Once the pilonidal cyst forms an abscess, this can be very painful, not to mention the risk of infection to the surrounding tissues.
Pilonidal sinus can greatly impair your daily life, which is why it is important that you get treated before the symptoms exacerbate. Home remedies can help manage the pain but they do not provide a lasting solution.
- At goficure, we have assembled a team of health experts in Bangalore for the treatment of pilonidal sinus.
- We also liaise with experienced surgeons in Bangalore so that you can receive timely treatment and alleviate your pain.
- We highly recommend laser surgery for the treatment of pilonidal sinus because the procedure is less invasive in comparison with conventional surgery.
- It means, therefore, that your recovery is faster and you can resume your daily routine sooner.
Laser surgery also reduces the risk of bleeding, takes a shorter time to administer, and is characterized by a higher rate of success. Also, it is associated with reduced post-procedure discomfort, while the chance of recurrence is greatly diminished.
- goficure has some of the most advanced equipment for conducting laser surgery in Bangalore.
- We also make arrangements with other specialty hospitals in Bangalore where you could get treated for your pilonidal sinus.
- Before surgery, we will have you picked up from home, assist you in filing the paperwork, and prepare you for surgery.
- We offer post-op care. We also liaise with qualified nutritionists in Bangalore who will guide you on the most effective diet plans to promote faster healing.
Exclusive features you get with goficure
1. Dedicated Medi-Pal
A dedicated Medi-Pal is assigned to you. Your Medi-Pal will be your one point contact throughout the treatment and post-op period. They will always be available for you
2. Quick doctor’s appointments
After understanding your concerns, your Medi-Pal will schedule your consultation with a specialist doctor. Your doctor will carry out necessary tests and advise the course of treatment
3. Hassle-free treatment
If you opt to get the surgery done, goficure will take care of it completely. Right from booking your surgery, claiming your insurance to being with you throughout the procedure, your Medi-Pal will do it all
4. Post-op recovery support
Your Medi-Pal would ensure quick recovery. This includes booking your follow up consultations and helping you with doctor-recommended steps for diet & exercise
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