PILONIDAL SINUS (INGROWN HAIR)

WHAT IS PILONIDAL SINUS (INGROWN HAIR)?

Ingrown hair and pilonidal sinus are the common and medical names of the disease, respectively. A pilonidal sinus develops due to ingrown hair under the skin. Although it develops most commonly in the coccygeal area, it may also occur in the navel, face, groin area, and under armpits.

It is most common at 15 to 35 years of age. It is seen in 10% of young males in our country. It is 3 times more frequent in men. We have observed that it develops in women more often in recent years. The disease incidence declines after 45 years of age.

WHY DOES IT DEVELOP?

Although it was considered a congenital disorder in the past, it is now recognized as an acquired disease. Three factors have been identified that pave the way for the hair roots to ingrow; including the intensity of hair in the area, the sensitivity of the skin,  and trauma and compression to cause hair to ingrow.

Friction on the skin results in the ingrowing of the hair through the sweat glands, creating edema and clogging.

A foreign body reaction develops, leading to subsequent abscess formation with the involvement of bacteria. The rupture of the abscess causes a sinus to develop.

The risk factors of developing a pilonidal sinus in the coccygeal area include having a deep intergluteal groove, being a young adult with intense hair growth, obesity, compression and friction due to long-term sitting, inadequate personal care, excessive sweating, and inflammation in hair follicles.

WHICH COMPLAINTS (SYMPTOMS) DOES THE DISEASE CAUSE?

Patients may complain of small lumps in the coccygeal area, itching, hair-containing or no-hair containing openings, and heavily smelling or odorless bloody discharge coming from these openings. Some patients present with severe pain and redness in the coccygeal area (pilonidal abscess).

Following the surgical drainage of the abscess, patients should undergo surgery to prevent recurrences.

HOW IS DIAGNOSIS MADE AND TREATMENT CARRIED OUT?

The diagnosis is usually made based on the medical history and findings of the physical examination. Surgical treatment appears to be the most effective method in the treatment of the disease.

 

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