Pilonidal sinus is a condition that is more commonly observed in men but also affects women.
While it predominantly develops in the sacrococcygeal region, it can also occur in other areas of the body, such as the back, neck, armpits, scalp, and navel.
There are various hypotheses regarding pilonidal sinus, but the widely accepted belief is not that hairs curl as they grow, but rather the movement of shed hairs towards negative pressure. Therefore, the cleanliness of body hair and personal hygiene plays a significant role in this condition.
While there are various opinions on the formation of pilonidal sinus, the most widely accepted view is that it arises when shed hairs from the body enter the skin through pores or openings, forming a cystic structure within the skin.
It is 2-3 times more common in men than in women, with the most prevalent age range being 15-35 years.
Pilonidal sinus can lead to symptoms such as abscess, pain, and foul-smelling discharge. Early diagnosis facilitates treatment. The disease can be largely controlled by ensuring good hygiene conditions and regularly cleaning body hair.
If pilonidal sinus has formed, it does not have the likelihood of self-healing. It is treated surgically. This should be complemented with the cleanliness of the hairs and personal care.
The symptoms of pilonidal sinus are initially observed as a discharge. If it becomes infected, the color of the discharge changes and becomes foul-smelling. The discharge may sometimes be bloody. As it progresses, it transforms into an abscess accompanied by itching, redness, swelling, and pain.
When an abscess forms, the resulting pain can disrupt the patient's daily activities and may even make sitting impossible. In such cases, it is essential to surgically drain the abscess and administer antibiotic treatment.
Once such a situation arises, after the completion of the treatment, surgical intervention should be considered to resolve the issue within 2 weeks. A sedentary lifestyle contributes to the development of the disease, making it common among individuals with desk jobs. Additionally, factors such as obesity, excessive sweating, abundant body hair, and poor hygiene increase the likelihood of the disease.
If an abscess has formed, it should be treated first. Pilonidal sinus surgery can be performed one month after abscess treatment. Abscess drainage is an easily performed procedure that can be done under local anesthesia and is highly effective. After the procedure, the patient may be able to sit, walk, and return to work.
Surgery is the most effective treatment for pilonidal sinus. In this condition, with various surgical techniques available, the choice of surgery depends on the size of the disease and the patient's condition. Non-surgical treatment methods are also available but are not as effective as surgery.
Every patient should be informed that the condition may recur, and they should seek medical attention when the first symptoms occur to prevent the disease from progressing.
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Prof. Dr. Sezai AydınGeneral Surgery Turkey
PROF. DR. SEZAI AYDIN
