Pilonidal Sinusitis

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.

Causes

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 sitting. 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.

Symptoms

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

Diet & Lifestyle Advice

Conservative Treatment : 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.

Lancing: 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.

Phenol Injection: 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.

Surgery: 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.