What causes pilonidal disease?
The condition results from infection around hairs embedded in the skin, commonly occurring in the cleft between the buttocks. Some people are born with small holes or pits near the base of the spine. These are in fact enlarged hair follicles,
which when subjected to friction and motion, are injured and disrupted so the hair pokes through the wall of the follicle into the surrounding skin setting up a foreign body reaction. Neighbouring hairs or free hairs from other parts of the body collect in the pit and invade the small opening created by the distorted hair follicles. Skin and perineal bacteria such as Staphylococcus aureus and Bacteroides species invade the opening and cause infection.
There are several common patterns of this disease. Nearly all patients have an episode of an acute abscess (the area is swollen, tender, and may drain pus). After the abscess resolves, either by itself or with medical assistance, many patients develop a pilonidal sinus. The sinus is a cavity below the skin surface that connects to the skin with one or more small openings or tracts. Although a few of these sinus tracts may resolve without therapy, most patients need a small operation to eliminate them since they frequently become infected. |
