Non – Surgical Pilonidal Sinus Treatment

In pilonidal sinus disease, the quality of life of patients can be significantly improved with the right treatment. Stitch-free and comfortable recovery can be achieved. As Avrupa Cerrahi, we achieve great success by using non-surgical methods in pilonidal sinus disease. Here are the pictures of our patient before treatment and after the non-surgical treatment we applied.

We treat patients who have been scheduled for surgery with non-surgical laser techniques using our 17 years of experience and expertise.

We follow all relevant information and developments in the field of proctology from domestic and foreign sources, and also apply our unique special treatment technology with innovative developments in this area.

Spinal hair disease is defined as Pilonidal Sinus in the medical literature. Pilonidal Sinus, a combination of the Latin words hair and socket, defined by Herbert Mayo in 1833, is a very common breech disease. The fact that it was considered as a congenital disease in the 80s has changed with the researches and it has been revealed that it is an acquired breech disease.

Although it is referred to as ingrown hair, the term that accurately describes the disease is hair cyst. Because Pilonidal Sinus (CYST) disease is not related to hair follicles, but is related to the hairs that settle under the skin from the outer surface of the body.

Although this breech disease, which is generally seen in young people and it’s more common in men, it can also occur in women.

Pilonidal Sinus occurs as a result of the accumulation of hair in the coccyx region, which is shed from areas of the body where the hair density is high, such as the back or waist area. It pierces the skin tissue in this area called the intergluteal sulcus and settles under the skin, causing a hair sac to form here. The body immune system reacts to this hair sac under the skin by forming a cystic structure over time.

Hair particles that settle under the skin from the outside are perceived as foreign bodies by the immune system. In order to prevent the progression of these foreign bodies coming from outside in the body, it takes these hair particles into a capsule in order to protect itself. Thanks to this inflamed capsule, called the hair sac, the hairs are kept together. Thus, it is tried to prevent its progression under the skin.

At the same time, a fluid accumulation occurs in the area for the destruction of foreign bodies by disintegration. This fluid known as an abscess, or inflammation, can sometimes leak from the hair entry holes and leave a discharge on the person’s clothes. In some cases, it gives symptoms such as hardness and swelling in the area without any discharge. Even if abscess does not occur, Pilonidal Sinus should be treated under all circumstances. Unless treated, it is not possible for the disease to go away on its own. A specialist proctology physician should be examined as soon as possible and the most appropriate treatment method for the patient should be started.

The effect of hair density in the region is great in the formation of Pilonidal Sinus. At the same time the sensitive skin structure in the intergluteal sulcus (coccyx) area is among the causes of the disease. To talk about the causes of Pilonidal Sinus in general:

• Dense hair in the breech and coccyx area, or excessive amount of hair falling from the back area,
• Easy irritation of the skin surface in the intergluteal sulcus area (the hollow area between the two buttocks)
• Keeping the skin surface moist with ingrown hairs
• The presence of cracks or scars in the coccyx area
• Local trauma
• Not paying attention to the hygiene of the coccyx and breech area
• Genetic predisposition
• Weight problems such as obesity
• Leading a sedentary life
• Sitting for a long time or Excessive sweating problem.

The symptoms of Pilonidal Sinus disease are as follows:

• The appearance of a pit in the coccyx region, or the presence of a mass in the region
• Bad odor due to swelling and discharge due to infection in the area
• The coccyx becomes very sensitive and the skin becomes red
• Bloody and purulent abscess discharges seen in the region
• Fatigue or high fever and nausea due to infection
• Difficulty sitting and walking due to severe pain

Pilonidal Sinus discomfort generally develops in and around the coccyx region. Although rare, it can also be seen in areas where there are hair clumps such as the armpits, groin area, face, neck or belly area. Early treatment of this disease, which is very uncomfortable for the patient in every sense is best for the patient.  patients are hesitant to talk about Pilonidal Sinus because it is a private area, and therefore they postpone seeing a doctor. However, this is a very wrong attitude. The longer the treatment of this disease is delayed, the more the infection increases. Due to the infection, different complaints such as high fever, nausea, fatigue, which affect not only the coccyx region, but also the whole body, arise.

Pilonidal Sinus is one of the breech diseases. Although an exact age range cannot be given, it is generally more common among adolescents. It is very common in individuals between the ages of 15-25. Individuals who are constantly on the move, sweat more due to hormones, and whose coccyx is more prone to irritation may face this disease at some point in their lives.

Experiencing weight problems, such as obesity, also triggers ingrown hairs. Excessive sweating which is seen as a result of excess weight, facilitates the progression of hair and causes irritation in the area, making it easier to settle under the skin. In addition, pilonidal sinus disease can be seen in people with a hard hair structure and high hair density.

The disease of Pilonidal sinus is often confused with another disease called ingrown hair. The two diseases are very different from each other. Both occur under the skin and are related to the hairs. However, apart from this similarity, Pilonidal Sinus and ingrown hairs are completely different diseases. While ingrown hair is a skin disease, Pilonidal Sinus is a breech disease.

The reason for ingrown hairs is the use of shaving or waxing due to cleaning. After these procedures, the hair structures that have roots under the skin and cannot reach the skin surface in this region begin to grow under the skin. The exit direction of these hairs and hairs, which are described as sunken, is reversed and causes discomfort to people in the future because they are stuck under the skin.

Hair rotation namely Pilonidal Sinus disorder, is caused by hair structures that spill from different parts of the body and accumulate in the coccyx and enter the skin from the outside. It is seen as a result of the formation of a cystic structure of the hairs that penetrate the skin tissue from the outside and settle under the skin.

• Occupations that work in a sitting position for a long time (desk jobs, long-distance driver, etc.),
• Disrupting the cleaning of the breech area and coccyx,
• These areas are not hygienic, not paying attention to this,
• Excessive sweating,
• Overweight problems, obesity,
• Not taking a shower regularly and often,
• Wound in the coccyx area due to other reasons,
• Genetic predisposition.

Paying attention to these risk factors is also important in terms of disease prevention.

There is no recurrence in Pilonidal Sinus. The situation that the person perceives as a recurrence is actually the formation of a brand new Pilonidal Sinus in the region. Recurrence is not seen in this ailment,  which is caused by external factors rather than internal skin. Only a new sinus formation is observed. Therefore, after the treatment, the person should continue to pay attention to the above-mentioned risk factors. For this reason, laser epilation is generally recommended for patients with ingrown hairs treatment in order to reduce the dense hair structure in the back, coccyx and waist area, and to prevent a new formation due to shedding hair. It is also recommended that people pay attention to the hygiene of the area and take frequent showers. Avoiding situations that will irritate the coccyx (wearing tight clothes, not preventing the area from sweating, not sitting upright)

There are different treatment approaches for Pilonidal sinus. Both the dimensions of the disease and in the method which the patient prefers are effective in the use of these approaches. For the initial stage discomfort, some physicians apply antibiotics, which are included in the preventive approach and aim to dry the infection in the region. First of all, this treatment method is a long-term method applied to eliminate the abscess. And it is only intended to heal the abscess. The hair sac inside cannot be removed with this treatment method. And long-term use of antibiotics also has negative effects on the patient.

As another method, the classical surgical method. It is a method that is very damaging to the healthy tissues in the region. In this method, an incision is applied to a large area in order to remove the piece of tissue with ingrown hairs, and the cut subcutaneous tissues (usually including healthy tissues) are removed. Then, the piece of skin removed by cutting is placed in the same place again and this time stitches are applied. In this method, a lot of destruction occurs in the region. In this case, the patient is faced with severe pain due to surgical wounds and a long recovery period. Of course, during this painful procedure, general anesthesia is applied. And therefore, hospitalization after the procedure is mandatory.

Due to the complications seen in the classical surgical method, non-surgical treatment methods are more preferred today. There are no large incisions in the non-surgical treatments for Pilonidal Sinus, which we also apply in our center. It is based on the removal of the abscess and hair follicle from the entrance and exit sinus holes in the region of the ingrown hair. The basic principle in the treatment of non-surgical Pilonidal Sinus is to remove the hair clipper without interfering with the healthy tissue. In this way, it is much more advantageous for patients than normal surgery. In this method, which we can consider as a small operation, local anesthesia is performed. In this way, no narcosis complications are observed. With this method, which is performed in a short time instead of a difficult surgical process, the person does not have a problem sitting or lying down after the procedure.