All about pilonidal sinus, the condition a 21-year-old UPSC aspirant has been diagnosed with

Pilonidal sinus, first identified during World War II, was diagnosed in a 21-year-old UPSC aspirant who was treated for it at a private hospital in Delhi. The condition, also known as Jeepers Bottom, involves pus formation near the tailbone, developed likely because the student used to sit for hours on library chairs, according to a PTI report. The condition worsened with increasing pus discharge and unbearable pain that eventually left him bedridden, the report noted.

The pus formed due to the collection of broken hair in a cavity below the skin.

What is the condition and why it happens?

A pilonidal sinus is a small hole or tunnel in the skin that exposes the person to an infection. “It is seen in the cleft at the top of the buttocks and needs immediate attention,” said Dr Rinky Kapoor, consultant dermatologist, cosmetic dermatologist and dermato-surgeon, The Esthetic Clinics.

The diagnosis of pilonidal sinus often begins with a thorough clinical evaluation involving a detailed examination, explained Dr Kapoor.

According to Dr Kapoor, the patients may be asked about their symptoms such as pain, swelling, or discharge. “An MRI can also be done to confirm the diagnosis of this condition. However, the symptoms are excruciating pain while sitting or standing, a cyst, and an unpleasant odour that will distress you,” said Dr Kapoor.

It is believed to be caused due to irritation caused by frictional irritation and ingrown hair in the area, and predisposed individuals are those with hormonal changes, obesity, friction from clothes, a sedentary lifestyle, and sitting for a long time.

The exact cause of a pilonidal sinus is not entirely understood, but several factors are believed to contribute. Dr Rajiv Kumar Bansal, senior consultant, general, Laparoscopic & Minimal Access Surgery, Sri Balaji Action Medical Institute, Delhi said one leading theory is that loose hairs penetrate the skin, causing an inflammatory response.

“Prolonged sitting, tight clothing, or activities that involve significant pressure on the tailbone area can contribute to the development of this condition. Hormonal changes during puberty, when hormone levels increase and body hair becomes thicker, may also play a role. Additionally, bacterial infection can occur when the skin is broken, leading to abscess formation,” said Dr Bansal.

What can be done?

Treatment for pilonidal sinus depends on the severity and whether an infection is present. “Common approaches include conservative treatments like good hygiene to keep the area clean and free of hair, and applying warm compresses to reduce pain and swelling,” said Dr Bansal.

According to Dr Kapoor, the treatment includes lancing for draining the pus, injection, and surgery. “Surgical options include incision and drainage, where a surgeon makes an incision to drain the abscess, or excision, where the sinus tract is surgically removed in recurrent cases,” said Dr Bansal.

It’s crucial to move (Source: Getty Images/Thinkstock)

Post-surgery care involves keeping the area clean, washing it properly as suggested by the doctor, drying the area completely, and avoiding sitting for a longer time.

According to Dr Kapoor, permanent laser hair removal from the area provides long-term relief. “This condition can be painful. Hence, it is important to seek timely intervention. Follow the instructions given by the doctor to manage this condition,” said Dr Kapoor.

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