What is ingrown hair (Pilonidal Sinus)?

In Latin, the word pilonidal means hair root, and sinus means space. In the coccyx, gaps are formed in the midline between both hips with holes of 1 mm into the skin. Thin hairs falling from the back, neck or buttocks fill these gaps, leading to infection. This condition is called ingrown hair. It is not certain how these hair root cavities occur. There are different theories suggesting that it may be congenital or acquired. Although it is common in young men between the ages of 15-30, it is not uncommon in women. It has been shown to occur more frequently in those who sit for a long time.

What are the symptoms of ingrown hair (pilonidal sinus) disease?

Usually, cysts due to ingrown hair do not show any symptoms. Sometimes a fine staining can be seen on the laundry due to the discharge. If infection or abscess develops, the discharge increases and severe pain may be experienced. In this case, the infection should be treated with early intervention. The biggest problem in this disease is that the area where ingrown hair occurs is in a place that remains moist and sweaty. It is difficult to clean this area due to its proximity to the anus. Factors that facilitate ingrown hair (pilonidal sinus) include;

• Being overweight
• Excess sweating
• Sitting constantly
• Being male
• Excessive body hair, especially the back
• Not paying attention to self-cleaning, not taking shower daily
• Shaving the area with a razor blade

How ingrown hair (pilonidal sinus) disease is treated?

If abscess has developed in the area, the treatment includes draining of the and antibiotic treatment. Definitive treatment can be performed after making sure that the infection is completely cleared. The treatment of ingrown hair can be performed with or without surgery. The main purpose of the non-surgical method is to clean the hair in these cysts, to burn and fill the cavities with special solutions. In eligible patients, sinuses are removed from the small incisions, followed by closing the area with stitches. Compared to the conventional surgical method, this approach is simpler, easier to apply and more comfortable for the patient after treatment. However, the risk of recurrence of the disease is higher in these treatment modalities and they are preferred only in theearly stages of the disease.

How ingrown hair (pilonidal sinus) surgery is performed?

Surgical treatment is required in patients who have had abscesses evacuated several times before or who the disease have recurred despite of previous interventions. The aim of the surgery is to remove all of the sinuses and to shift the coccyx pit where the disease occurs to prevent recurrence of the disease. In eligible patients, the wound can be closed with stitches or with flap, a tissue that is slid from the side hip once the problematic part is removed. In advanced cases, the wound can heal without stitches after the diseased tissue is removed.

How the postoperative care of ingrown hair (pilonidal sinus) is performed?

The coccyx region is a difficult place for wound care due to its location sincethe area is constantly stretched due to sitting and standing as well as prone to sweating. In addition, due to its proximity to the anus, it is prone to contamination during defecation. While the care of non-surgical methods employed for the treatment of ingrown hair is much easier, it may be very difficult when the treatment option is a surgical method. The area operated should be kept dry and clean, and the patient should spend the first few weeks lying down rather than sitting. For this reason, it may take up to 4 weeks for patients to return to work after surgery and 6-8 weeks for them to return to their normal daily life without any problems.

Does ingrown hairs (pilonidal sinus) recur after surgery?

The short-term recurrence of the disease depends on postoperative wound care.The possibility of recurrence is very low in patients who have completed postoperative wound healing without any problems. I recommend my patients to remove hair and hair follicles with laser epilation atthe coccyx area, take showers daily, and change clothes frequently to keep this area dry.