Pilonidal Sinus
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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 odour Pilonidal means a 'nest of hairs’. A sinus tract is a narrow tunnel (a small abnormal channel) in the body. A sinus tract typically goes between a focus of infection in deeper tissues to the skin surface. This means that the tract may discharge pus from time to time on to the skin.
Causes
1. Most doctors think that ingrowing hairs cause pilonidal sinuses. Pilonidal means "nest of hair". It is common to find hair follicles inside the sinus.
2. Another theory is that pilonidal sinuses appear after an injury to the sacrococcygeal region (the region relating to both the sacrum [the lower vertebrae] and coccyx).
3. People thought the sinuses were due to irritation from riding in bumpy vehicles.
4. A job involving a lot of sitting (a sedentary occupation)
5. Being overweight (obesity)
6. A previous persistent irritation or injury to the affected area
7. Having a hairy, deep natal cleft
8. A family history of the condition
This condition used to be called 'jeep seat', as it was common in army jeep drivers. This was probably a result of many hours driving and 'bouncing' on a hard seat, which caused irritation, minor injury and pressure around the natal cleft.
Symptoms
When it's infected, a pilonidal cyst becomes a swollen mass (abscess). Signs and symptoms of an infected pilonidal cyst include:
1. Pain
2. Reddening of the skin
3. Drainage of pus or blood from an opening in the skin
4. Foul smell from draining pus
5. If you have no symptoms then you will normally be advised to clear the affected area of hairs (by shaving, etc.) and to keep the area clean with good personal hygiene.
6. Pain at the bottom of the spine.
7. Swelling at the bottom of the spine.
8. Redness at the bottom of the spine.
9. Draining pus.
10. Raised temperature with any of the above symptoms.
Pilonidal sinus treatment self-care at home
Early in an infection of a pilonidal sinus, the redness, swelling and pain may be minimal. Sitting in a warm bath may decrease the pain and may also decrease the chance that the sinus will develop to the point of requiring incision and drainage.
When to Seek Medical Care for a Pilonidal Cyst?
A pilonidal cyst is an abscess or boil. It needs to be drained, or lanced, to improve. Like other boils, it does not improve with antibiotics. If any of the above symptoms occur, consult a doctor
Prevention
You may help heal the infection and prevent it from happening again by:
1. keeping your buttock cleft clean and dry
2. using a mild soap and making sure all soap is removed after cleaning
3. shaving the area regularly or using a hair-removal product
4. soaking in a warm tub (sitz bath) a few times a day
5. taking pain relief medication
6. Avoiding sitting for long periods.
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