Pilonidal cysts are cavities or cysts, mostly located in the tailbone area, that contain hair, hair clumps, and pus. They can also occur in the armpits, groin, navel, and between the fingers. Previously thought to be congenital, this condition is now considered acquired. There are several causes and risk factors that facilitate ingrown hair disease:
Causes of Ingrown Hair
- Excessive body hair and daily shedding of hair
- A narrow and deep crevice between the buttocks (This causes the shedding hairs to remain in the narrow and deep groove for a long time due to the increased suction force applied to the hairs)
- The skin remaining moist for a long time (This makes it easier for hairs to become ingrown)
- The presence of cracks or scar tissue in the crevice between the buttocks
- Working while sitting for long periods (The accumulated hairs constantly cause injury in this area)
- Poor hygiene
Risk Groups
- People between the ages of 20-40
- Those who work while sitting for long periods (desk) (Office workers, students, drivers, etc.)
- Men
- Those with dense hair
- Those with dark skin
Symptoms of Pilonidal Cyst
- Swelling
- Pain
- Chronic discharge
Diagnosis
When the patient consults a doctor, a visual examination is performed and the rotation in the tailbone area is seen. Although very rare, MRI can be used if there is any doubt.
Treatment of Pilonidal Cyst
In the case of an abscessed pilonidal cyst, the abscess is drained under regional (local) or general anesthesia. Antibiotics and anti-inflammatory drugs are added to the treatment. However, the main treatment for the disease is surgery.
Microsinusectomy: In small cysts, this involves injecting phenol/silver nitrate into the cyst and removing the skin openings. The recurrence rate is around 50%. It is used in limited cases.
Open surgical method: The cyst is removed as is, leaving the tissue open. The healing time is long, it is painful due to continuous dressings, and the probability of recurrence is high.
Closed method (Limberg rotation flap): In this method, which we also use, the cyst is removed in a diamond shape. The open area is closed with skin/subcutaneous fatty tissue shifted from the right hip, and a drainage drain is placed. It is performed under spinal anesthesia (numbing from the waist). It takes approximately 30 minutes. The patient is discharged the next day. The stitches are removed after 9-10 days, and the process is complete. It is recommended not to sit except during meals and toilet use for the first week.
Its advantages include quick recovery, postoperative pain comfort and low risk of recurrence (1-2).
