What are the other Names for this Condition? (Also known as/Synonyms)

• Pilonidal Sinus Disease

What is Pilonidal Sinus? (Definition/Background Information)

• Pilonidal Sinus is a condition that affects the lower spinal region, near the tailbone (or the coccyx). The condition results in the formation of a sinus tract, from the skin tissues to the deeper (subcutaneous) tissues
• Pilonidal Sinus is often seen in young adults. The cause of the condition is unknown, but it may be influenced by factors such as prolonged sitting. A Pilonidal Sinus can also be present as part of follicle occlusion syndrome (a widespread skin condition)
• The condition may be treated per its severity. This may include the use of topical applications and antibiotics, if infection is noted
• The prognosis of Pilonidal Sinus depends upon several factors including on the severity of the signs and symptoms, but is generally excellent with adequate treatment

Who gets Pilonidal Sinus? (Age and Sex Distribution)

• Pilonidal Sinus is rare and can occur at any age; usually young adults are affected the most
• Both males and females are affected, but a male predominance is seen
• Individuals of all racial and ethnic background may be affected

What are the Risk Factors for Pilonidal Sinus? (Predisposing Factors)

The risk factors for Pilonidal Sinus may include the following:

• Obesity
• Excessive body hair, or the presence of coarse hair on the body
• Prolonged sitting by nature of one’s occupation
• Lifestyle lacking physical activities and exercises
• Positive family history of the condition
• Trauma to the tailbone region
• Lack of proper personal hygiene
• It can form a part of follicular occlusion syndrome along-with other skin conditions that include hidradenitis suppurativa, acne conglobata, and dissecting cellulitis of scalp

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Pilonidal Sinus? (Etiology)

The cause of development of Pilonidal Sinus is currently unknown.

• This condition develops when a Pilonidal Sinus tract forms in the skin around the tailbone
• This may occur due to constant/continuous sitting causing the hair on the coccyx or tailbone to pierce into the skin. It may even form from minor trauma to the region
• Factors that may influence the formation of a Pilonidal Sinus tract includes obesity and friction between the skin and clothing

It is important to note that this condition is not a skin infection that spreads via direct physical contact.

What are the Signs and Symptoms of Pilonidal Sinus?

The signs and symptoms of Pilonidal Sinus may include:

• The presence of Pilonidal Sinus tract, which appears like a groove or a tiny depression on skin in the furrow of the buttocks (around the tailbone)
• The skin in the region may be reddish, inflamed, and painful
• The individual may have trouble sitting

How is Pilonidal Sinus Diagnosed?

A diagnosis of Pilonidal Sinus may involve the following:

• A thorough medical history and physical examination: In most cases, Pilonidal Sinus is diagnosed based on the presenting symptoms and no further lab tests may be necessary
• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Radiological imaging studies to search for underlying bony abnormalities

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Pilonidal Sinus?

Pilonidal Sinus may result in the following complications:

• Formation of a pilonidal cyst with abscess formation
• Prolonged discomfort and pain
• Complications from underlying follicle occlusion syndrome (if present)

How is Pilonidal Sinus Treated?

The treatment of Pilonidal Sinus Disease is based upon the severity of the condition and may involve the following:

• For mild skin conditions, self-care measures are recommended, such as washing with mild soap (antibacterial) and applying warm compress
• Topical applications
• Medications, such as antibiotics, may be used for bacterial infection
• In case it is associated with follicle occlusion syndrome, then treatment of the underlying condition is necessary

How can Pilonidal Sinus be Prevented?

Currently, there are no known methods to prevent Pilonidal Sinus occurrence.

What is the Prognosis of Pilonidal Sinus? (Outcomes/Resolutions)

• The prognosis of Pilonidal Sinus depends upon the severity of the signs and symptoms and the response to treatment
• In most cases, the prognosis of the condition is excellent with adequate treatment

Additional and Relevant Useful Information for Pilonidal Sinus:

• There is no evidence to prove that oily foods and chocolate-based products have an influence on Pilonidal Sinus formation
• Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition
• The presence of dirt on the body is not a causative factor for the condition. However, it helps to be clean and hygienic, which may help the condition from getting worse