Pilonidal Sinus (PNS) Causes, Symptoms And Treatment

A pilonidal sinus is a small hole, tunnel, cyst and abscess that occur in the cleft at the top of buttock near the tailbone. The term pilonidal means nest of hair. It may have a sinus tract that connects it with the skin. Actually there is an inflammation of sinuses in the midline of buttocks that contains debris and hairs. It is a common problem among males and young adults. It is more common after puberty. Dark hair and caucasian males are more susceptible to pilonidal sinus.

Causes

The exact cause of the pilonidal is still unknown. It is believed to be caused by hormonal changes that cause excessive hair growth. The prolonged sitting job or habit and friction generated by clothes also have the ability to cause pilonidal sinus. It may also be caused by bad body hygiene and infection. It is rarely present congenitally as an embryological cause. Increased moisture and sweating can also cause pilonidal sinus. Obesity, sedentary occupation and local irritation or traumas are also associated with this disease. Due to the friction of buttock, the shear forces are produced in the natal cleft. This allows the broken or shed hairs to collect in the natal cleft and enter into the skin. Your body considers these hairs as foreign particles and produces an immune response against these hair follicles. This immune response produces cyst around the hair follicles.

Symptoms

Pilonidal sinus does not cause any symptoms unless infection occurs. The symptoms may vary from small hollow cleft to a large painful abscess. The clinical presentation includes,

• Pain during sitting and bending
• Intermittent clear, cloudy and bloody discharge
• Reddish and sore skin
• Swelling of cyst
• Foul smelling excretions from cyst
• Fever and malaise (reported in undrained abscess)

Treatment

If your pilonidal sinus is diagnosed in its early stage and there are no symptoms of pain and inflammation, your doctor may prescribe you some painkillers, anti-inflammatory and antibiotics. The antibiotics are given to prevent the infection and anti-inflammatory and painkillers to reduce the signs of swelling and pain. These medicines will give you temporary relief and that’s why you must have to get follow up checkups. You should regularly remove hairs from that site and maintain proper hygiene and apply antimicrobial creams. There are two types of surgeries performed in pilonidal sinus, minor and major surgery. Both surgeries are performed under local anesthesia. In minor surgery, a small cut is made on the cyst and pus is allowed to drain out. Lancing and phenol injections are included in minor surgeries. If the infection is severe, then your doctor will make a large cut and cyst will be removed. The recurrence of pilonidal sinus is very high after surgery, mostly within six months.