Due to its sensitive location, pilonidal sinus disease causes exquisite pain to many thousands of men every year. Treatment usually involves drainage, meticulous cleansing and debriding, and the administration of broad-spectrum antibiotics.
What is a Pilonidal Cyst or Jeep Disease?
An epithelial track known as a pilonidal sinus devolops in the skin of the natal cleft, located behind the anus, near the tailbone. The painful cysts which develop in this region often contain hair which is how the condition came to have its name. In Latin, piloniadal means nest of hairs.
The term Jeep Disease is a common name for the same condition. It originated during World War II when Army doctors found that the pilonidal disease was most prevalent among jeep drivers.
Who Gets Pilonidal Sinus?
Young men are the primary victims of this painful condition. It rarely occurs in boys before puberty or in men older than forty, and it is rarer still in women. Caucasians are also at higher risk of developing PNS than Asians and Africans. Other risk factors include:
- Family history
- Sedentary occupation
- Obesity
- Local trauma or irritation
How Does a Pilonidal Abscess Develop?
Doctors do not fully understand how PNS develops but most agree on four major contributing factors:
- Hormones
- Hair
- Friction
- Infection
Therefore, it is believed that the disease develops in the following manner.
- Increased production of sex hormones at puberty increases hair growth and causes the sebaceous glands to enlarge.
- Further enlargement and stretching of these oil producing glands is caused by the weight of the buttocks being pulled over the area of the tailbone.
- Slumping or bouncing on a hard surface while seated increases this stretching even more.
- Finally, natural friction between the buttocks results in keratin and hair being sucked into the stretched follicles causing the formation of a pilonidal abscess.
How is PNS Treated?
In less severe cases of pilonidal disease antibiotics, meticulous hair removal (depilation) and careful cleansing may be enough to correct the problem.
More advanced cases, however, will likely need to be drained and packed, or even surgically removed and closed. Proper hygiene and wound care, including continued hair removal, are essential following this sort of procedure in order to prevent a recurrence of the condition and secondary infection.
Preventing Pilonidal Sinus by Shaving
In 2009, Diseases of the Colon & Rectum published a study which concluded, “razor hair removal increases the rate of long-term recurrence after surgery for pilonidal sinus and should not be recommended.”
The authors speculated that shaving might have resulted in micro-traumas to the skin which caused hair to grow in the wrong direction. They proposed the consideration of laser hair removal as an alternative to shaving.
A 2002 study published by the Royal College of Surgeons of England had arrived at the same conclusion.
Reference:
- Odili J, Gault D. Laser depilation of the natal cleft – an aid to healing the pilonidal sinus. Ann R Coll Surg Engl 2002; 84: 29-32. Retrieved August 27, 2011 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2503766/pdf/annrcse01635-0037.pdf
- Petersen S, Wietelmann K, Evers T, Hüser N, Matevossian E, Doll D. Long-term effects of postoperative razor depilation in pilonidal sinus disease. Dis Colon Rectum 2009; 52(1): 131-34.
- Miller D, Harding K. (2003) Pilonidal sinus disease. World Wide Wounds. Retrieved August 27, 2011 from http://www.worldwidewounds.com/2003/december/Miller/Pilonidal-Sinus.html
- Venes, D. (2005). Taber's cyclopedic medical dictionary (20th ed.). Philadelphia: F.A. Davis Company.
Maria Blanco - Writer/Editor, Certified Family Herbalist, Naturopath, Holistic Nutritional Consultant
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