A pilonidal sinus is a common development associated with a pilonidal abscess, which occurs near the sacral area of the spine, often around the tailbone. Treatment can include warm compresses, antibiotics, or surgery.
A pilonidal sinus is a common development associated with a pilonidal abscess. Pilonidal abscesses, also known as pilonidal cysts, are areas of abscesses that occur near the sacral area of the spine, often occurring around the tailbone, between the buttocks. Occasionally, the abscess develops a small sinus tract that drains onto the surface of the skin, allowing material from inside the abscess to drain. This sinus tract is known as the pilonidal sinus.
Young adult males are more likely to develop a pilonidal abscess. The term “pilonidal” means “nest of hair,” reflecting the fact that hair is often found within the abscess, along with skin debris. It is also not uncommon for opportunistic bacteria to become lodged in the abscess, causing disease in the patient. Such abscesses are usually very painful, mainly because they are in an area of the body that is put under pressure whenever someone sits down.
The causes of pilonidal abscesses are not well understood. Some doctors suspect that they originate from ingrown hairs, while others believe that they may be the result of heavy sweating, trauma to the region or even pressure that could be caused by long periods of sitting. Pilonidal abscess and associated 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 may play a significant role.
When this condition develops, a small hole appears above the anus. The hole may drain or leak fluid, including foul-smelling fluid that indicates the presence of a bacterial infection. Patients usually experience pain or discomfort, as well as soiling their underwear from leaking fluids.
Treatment for a pilonidal sinus and underlying abscess can be as simple as applying warm compresses to promote drainage and using antibiotics to encourage healing of the abscess. In some cases, surgery to remove the abscess may be recommended. Surgery is also used if a doctor cannot confirm that the problem is indeed a pilonidal abscess, as different medical problems such as teratomas can look similar, and it may be best to remove the suspicious area of tissue, just to be sure.
As a general rule, a pilonidal sinus and abscess do not resolve on their own, and treatment is strongly recommended to prevent infection, confirm the diagnosis, and resolve associated pain. Many general practitioners or nurse practitioners can provide treatment for a pilonidal cyst and may refer a patient to a surgeon if surgery is thought to be a better treatment option.
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