What is a Pilonidal Sinus?

Mary McMahon
Mary McMahon
A pilonidal sinus may occur as a result of sitting for extended periods of time.
A pilonidal sinus may occur as a result of sitting for extended periods of time.

A pilonidal sinus is a common development associated with a pilonidal abscess. Pilonidal abscesses, also known as pilonidal cysts, are areas of abscess which occur near the sacral area of the spine, often manifesting around the coccyx, between the buttocks. Occasionally, the abscess develops a small sinus tract which drains to the surface of the skin, allowing material from inside the abscess to drain out. This sinus tract is known as a pilonidal sinus.

A pilonidal sinus may occur as a result of excessive sweating.
A pilonidal sinus may occur as a result of excessive sweating.

Young adult males are most likely to develop a pilonidal abscess. The term “pilonidal” means “nest of hair,” reflecting the fact that hair is often found inside the abscess, along with skin debris. It is also not uncommon for opportunistic bacteria to settle in the abscess, causing disease in the patient. Such abscesses are usually very painful, especially because they are located on an area of the body which is subjected to pressure every time someone sits down.

Military drivers may be susceptible to developing a pilonidal sinus.
Military drivers may be susceptible to developing a pilonidal sinus.

The causes of pilonidal abscesses are not well understood. Some doctors suspect that they originate in ingrown hairs, while others believe that they may be the result of heavy sweating, trauma to the region, or even pressure which might be caused by extended periods of sitting. The pilonidal abscess and accompanying pilonidal sinuses have a long history in the military, especially among drivers who routinely handle rough terrain, suggesting that the dual factors of trauma and pressure can play a significant role.

Antibiotics may be helpful in treating a pilonidal sinus.
Antibiotics may be helpful in treating a pilonidal sinus.

When this condition develops, a small hole appears above the anus. The hole may drain or leak fluid, including foul smelling fluid which indicates the presence of bacterial infection. Patients usually experience pain or discomfort, as well as soiling of underwear from the leaking fluids.

Treatment for a pilonidal sinus and the underlying abscess can be as simple as applying hot compresses to promote drainage and using antibiotics to encourage the abscess to heal. In some cases, surgery may be recommended to excise the abscess. Surgery is also used if a doctor cannot confirm that the problem is really a pilonidal abscess, as several medical problems such as teratomas can look similar, and it may be better to take the suspicious area of tissue out, just to be safe.

Some doctors believe pilonidal sinus can be caused by ingrown hairs.
Some doctors believe pilonidal sinus can be caused by ingrown hairs.

As a general rule, a pilonidal sinus and abscess will not resolve on their own, and treatment is strongly recommended to prevent infection, confirm the diagnosis, and to resolve the associated pain. Many general practitioners or nurse practitioners can provide treatment for a pilonidal cyst, and can refer a patient to a surgeon is surgery is believed to be a better treatment option.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a TheHealthBoard researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a TheHealthBoard researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

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anon356097

Will it go away on its own?

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    • A pilonidal sinus may occur as a result of sitting for extended periods of time.
      By: Ivonne Wierink
      A pilonidal sinus may occur as a result of sitting for extended periods of time.
    • A pilonidal sinus may occur as a result of excessive sweating.
      By: lulu
      A pilonidal sinus may occur as a result of excessive sweating.
    • Military drivers may be susceptible to developing a pilonidal sinus.
      By: angellodeco
      Military drivers may be susceptible to developing a pilonidal sinus.
    • Antibiotics may be helpful in treating a pilonidal sinus.
      By: Africa Studio
      Antibiotics may be helpful in treating a pilonidal sinus.
    • Some doctors believe pilonidal sinus can be caused by ingrown hairs.
      By: F.C.G.
      Some doctors believe pilonidal sinus can be caused by ingrown hairs.
    • Some pilonidal sinus cases may require surgery to excise the abscess.
      By: Radu Razvan
      Some pilonidal sinus cases may require surgery to excise the abscess.
    • A pilonidal abscess will usually manifest around the coccyx bone.
      By: photoBeard
      A pilonidal abscess will usually manifest around the coccyx bone.