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• #1 Pilonidal Cysts: Causes, Symptoms & TreatmentAccessibility ToolsIncrease TextDecrease TextGrayscaleHigh ContrastNegative ContrastLight BackgroundLinks UnderlineReadable FontReset

  https://pilonidalinstitute.com/pilonidal-cyst/

  A chronic skin infection that forms near your tailbone in the top crease of your buttocks, a pilonidal cyst is known for causing excruciating pain. They develop when hairs in the cleft of your buttocks grow into your skin and become infected. Risk factors include: […] While pilonidal cysts occur more frequently in men than in women, they are also more common in people of Middle Eastern and Caucasian descent than in other racial groups. […] Pilonidal cysts were first described in 1833 by Herbert Mayo. The term pilonidal is derived from the Latin words “pilus” (hair) and “nidus” (nest).

• #2 Pilonidal Cyst: Symptoms, Causes, & Treatment

  https://www.webmd.com/skin-problems-and-treatments/pilondial-cyst

  Pilonidal cysts can be treated. If your cyst becomes a problem, your doctor can drain it or take it out through surgery. […] Researchers think that ingrown hairs cause pilonidal cysts. Pilonidal means „nest of hair,” and doctors sometimes find hair follicles inside the cyst. […] During World War II, more than 80,000 soldiers got pilonidal cysts that put them in the hospital. People thought they were because of irritation from riding in bumpy Jeeps. For a while, the condition was called „Jeep disease.” […] You might be more likely to get one if you were born with a small dimple in the skin between your buttocks, called a sacral dimple. This harmless dimple could get infected and result in a pilonidal cyst, though doctors aren’t exactly sure why. […] It’s possible to inherit a pilonidal cyst from a relative. For example, if thick, coarse body hair runs in your family, you are more likely to get a cyst.

• #2 Pilonidal Cyst and Sinus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557770/

  Early after its description, many clinicians considered the disease as congenital in origin, being derived from vestiges of the medullary tube, dermoid traction, inclusion dermoid, or preen glands. Currently, pilonidal disease is considered an acquired disease. Patey et al. proposed the hypothesis of pilonidal disease being an acquired disease, suggesting that pilonidal disease results from the suction of hair from surrounding soft tissue and skin, ultimately leading to a foreign body reaction and foreign body granuloma. This proposal of pilonidal disease being an acquired, infective, and foreign body reaction was corroborated by King around the same time. […] Karydakis simplified the description of the etiologic process citing three main factors- the hair or foreign body, a force causing deposition of hair into the sinus, and skin vulnerability.

• #3

  https://journals.lww.com/dcrjournal/abstract/2000/43080/pilonidal_cyst__cause_and_treatment.18.aspx

  There is nearly a consensus that pilonidal cyst is acquired, hair being the agent that causes the disease. […] The majority of authors conclude that sacrococcygeal pilonidal cyst is an acquired disease, although a minority believe it is congenital.

• #4 Pilonidal Disease: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/192668-overview

  Pilonidal disease is now widely considered to be an acquired disorder, on the basis of observations that congenital tracts do not contain hair and are lined with cuboidal epithelium. The pilonidal cyst is also not a true cyst, in that it has an epithelialized walls and is more of a cavity, which makes a congenital origin less likely. The recurrence of the disorder after complete excision of the disease tissue down to the sacrococcygeal fascia and the high incidence of chronic pilonidal sinus disease in patients who are hirsute further support an acquired theory of pathogenesis. […] The etiology of pilonidal disease has been surrounded by controversy. In the 1950s, as noted (see above), the predominant thinking was that this was a congenital condition. Since then, however, theories have come to focus primarily on predisposing factors and acquired conditions.

• #5 Pilonidal Cyst and Sinus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557770/

  Early after its description, many clinicians considered the disease as congenital in origin, being derived from vestiges of the medullary tube, dermoid traction, inclusion dermoid, or preen glands. Currently, pilonidal disease is considered an acquired disease. Patey et al. proposed the hypothesis of pilonidal disease being an acquired disease, suggesting that pilonidal disease results from the suction of hair from surrounding soft tissue and skin, ultimately leading to a foreign body reaction and foreign body granuloma. This proposal of pilonidal disease being an acquired, infective, and foreign body reaction was corroborated by King around the same time. […] Karydakis simplified the description of the etiologic process citing three main factors- the hair or foreign body, a force causing deposition of hair into the sinus, and skin vulnerability.

• #6 Pilonidal Cyst and Sinus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557770/

  Early after its description, many clinicians considered the disease as congenital in origin, being derived from vestiges of the medullary tube, dermoid traction, inclusion dermoid, or preen glands. Currently, pilonidal disease is considered an acquired disease. Patey et al. proposed the hypothesis of pilonidal disease being an acquired disease, suggesting that pilonidal disease results from the suction of hair from surrounding soft tissue and skin, ultimately leading to a foreign body reaction and foreign body granuloma. This proposal of pilonidal disease being an acquired, infective, and foreign body reaction was corroborated by King around the same time. […] Karydakis simplified the description of the etiologic process citing three main factors- the hair or foreign body, a force causing deposition of hair into the sinus, and skin vulnerability.

• #7 Pilonidal Disease: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/192668-overview

  Pilonidal disease is now widely considered to be an acquired disorder, on the basis of observations that congenital tracts do not contain hair and are lined with cuboidal epithelium. The pilonidal cyst is also not a true cyst, in that it has an epithelialized walls and is more of a cavity, which makes a congenital origin less likely. The recurrence of the disorder after complete excision of the disease tissue down to the sacrococcygeal fascia and the high incidence of chronic pilonidal sinus disease in patients who are hirsute further support an acquired theory of pathogenesis. […] The etiology of pilonidal disease has been surrounded by controversy. In the 1950s, as noted (see above), the predominant thinking was that this was a congenital condition. Since then, however, theories have come to focus primarily on predisposing factors and acquired conditions.

• #8 Pilonidal cyst – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pilonidal-cyst/symptoms-causes/syc-20376329

  A pilonidal cyst is an unusual pocket in the skin that usually contains hair and skin debris. […] Pilonidal cysts usually occur when hair punctures the skin and then becomes embedded. […] The cause of most pilonidal cysts is loose hairs that puncture the skin. Friction and pressure from rubbed skin, tight clothing, cycling or long periods of sitting can force hair into the skin. […] The body creates a cyst around the hair to try to push it out. Most pilonidal cysts form on the tailbone. People who groom animals or cut hair can develop a cyst between their fingers.

• #9 Pilonidal Sinus: Causes, Symptoms, and Treatments

  https://www.healthline.com/health/pilonidal-cyst

  A pilonidal sinus infection mostly affects men and is also common in young adults. Its also more common in people who sit a lot, like cab drivers. […] The exact cause of an infected pilonidal sinus isnt known, but its believed to be a combination of changing hormones (because it occurs after puberty), hair growth, and friction from clothes or from spending a long time sitting. […] Activities that cause friction, like sitting, can force the hair growing in the area to burrow back under the skin. The body considers this hair foreign and launches an immune response against it, similar to how it would react when dealing with a splinter. […] This immune response forms the cyst around your hair. Sometimes a person may have multiple sinuses that connect under the skin.

• #10 Pilonidal Cyst (for Parents) – Humana – Ohio

  https://kidshealth.org/HumanaOhio/en/parents/pilonidal-cyst.html

  Doctors think that pilonidal cysts form when loose hair and dead skin cells get trapped under the skin. […] The immune system treats the hair and dead skin cells as foreign, and forms a cyst around them that fills with fluid. […] A pilonidal cyst can be more likely if someone: is born with a dimple or pit in their tailbone area, spends a lot of time in a sitting position, is overweight, has a lot of body hair, especially if it’s thick or coarse, wears tight clothing that presses on the tailbone area, has family members with a pilonidal cyst.

• #11 Pilonidal Sinus: Causes, Symptoms, and Treatments

  https://www.healthline.com/health/pilonidal-cyst

  A pilonidal sinus infection mostly affects men and is also common in young adults. Its also more common in people who sit a lot, like cab drivers. […] The exact cause of an infected pilonidal sinus isnt known, but its believed to be a combination of changing hormones (because it occurs after puberty), hair growth, and friction from clothes or from spending a long time sitting. […] Activities that cause friction, like sitting, can force the hair growing in the area to burrow back under the skin. The body considers this hair foreign and launches an immune response against it, similar to how it would react when dealing with a splinter. […] This immune response forms the cyst around your hair. Sometimes a person may have multiple sinuses that connect under the skin.

• #12 Pilonidal Cyst | UMass Memorial Health

  https://www.ummhealth.org/health-library/pilonidal-cyst

  The cause of pilonidal cysts has been debated since they were first recognized. Most likely, the cause may be a combination of: […] Ingrown hairs. This happens when a hair is forced under the skin or when a hair follicle breaks open (ruptures). […] Injury to the area. Injury, rubbing, or skin irritation may cause pilonidal cysts. This can happen from sitting for long periods of time. It can be more common in people who sit or drive a lot for work.

• #13 Pilonidal disease – Wikipedia

  https://en.wikipedia.org/wiki/Pilonidal_disease

  Pilonidal cysts may be caused by a congenital pilonidal dimple. […] Hair insertion is the causative agent of pilonidal cysts. […] One proposed cause is ingrown hair, although hairs found in pilonidal sinus tracts have more often been found to originate from the head. […] Excessive sitting is thought to predispose people to the condition, as sitting increases pressure on the coccygeal region. […] Trauma is not believed to cause a pilonidal cyst; however, such an event may result in inflammation of an existing cyst; there are cases where this can occur months after a localized injury to the area. […] Excessive sweating can also contribute to the formation of a pilonidal cyst: moisture can fill a stretched hair follicle, which helps create a low-oxygen environment that promotes the growth of anaerobic bacteria, often found in pilonidal cysts.

• #14 Pilonidal Disease: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/192668-overview

  The incidence of pilonidal disease is also affected by hair characteristics, such as kinking, medullation, coarseness, and growth rate. White persons are affected more frequently than are African or Asian persons. Other factors affecting the disease’s incidence are increased sweating activity associated with sitting and buttock friction, poor personal hygiene, obesity, and local trauma, which help to explain why pilonidal sinus disease is common in army recruits. […] Predisposing factors to pilonidal disease are believed to include the following: Obesity, Sedentary lifestyle or occupation, Deep natal cleft, Family history of pilonidal disease. […] In an article examining the condition in Turkish soldiers, the incidence was found to be 8.8%, with the correlation factors known to be family history, obesity, being the driver of a vehicle, and the presence of folliculitis or a furuncle at another site on the body.

• #15 What Is Pilonidal Cyst? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/pilonidal-cyst/guide/

  Some factors may increase the risk of getting a pilonidal cyst. Among them: being obese, being inactive, working at a job that requires long sitting times (such as truck driving), having excess body hair, having stiff or coarse hair, having poor hygiene. […] Sometimes, pilonidal cysts are hereditary. Rough body hair and ingrown hairs may run in your family, increasing your risk of developing a cyst.

• #16 Pilonidal Cyst and Sinus Clinical Presentation: History, Physical, Causes

  https://emedicine.medscape.com/article/788127-clinical

  Pilonidal disease is acquired, not congenital, and involves loose hair and skin and perineal flora. […] Risk factors for pilonidal disease include male gender, hirsute individuals, Caucasians, sitting occupations, existence of a deep natal cleft, and presence of hair within the natal cleft. Family history is seen in 38% of patients with pilonidal disease. Obesity is a risk factor for recurrent disease. […] The most commonly reported bacteria cultured from pilonidal abscesses differ by study. In one study, anaerobic cocci were present 77% of the time; aerobic, 4%; and mixed aerobic and anaerobic, 17%. Other studies quote Staphylococcus aureus, an aerobe, as being the most common bacterial pathogen.

• #17 Pilonidal Disease: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/192668-overview

  The incidence of pilonidal disease is also affected by hair characteristics, such as kinking, medullation, coarseness, and growth rate. White persons are affected more frequently than are African or Asian persons. Other factors affecting the disease’s incidence are increased sweating activity associated with sitting and buttock friction, poor personal hygiene, obesity, and local trauma, which help to explain why pilonidal sinus disease is common in army recruits. […] Predisposing factors to pilonidal disease are believed to include the following: Obesity, Sedentary lifestyle or occupation, Deep natal cleft, Family history of pilonidal disease. […] In an article examining the condition in Turkish soldiers, the incidence was found to be 8.8%, with the correlation factors known to be family history, obesity, being the driver of a vehicle, and the presence of folliculitis or a furuncle at another site on the body.

• #18 What Is Pilonidal Cyst? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/pilonidal-cyst/guide/

  Some factors may increase the risk of getting a pilonidal cyst. Among them: being obese, being inactive, working at a job that requires long sitting times (such as truck driving), having excess body hair, having stiff or coarse hair, having poor hygiene. […] Sometimes, pilonidal cysts are hereditary. Rough body hair and ingrown hairs may run in your family, increasing your risk of developing a cyst.

• #19 Pilonidal Cyst: Causes, Symptoms, Treatments & Removal

  https://my.clevelandclinic.org/health/diseases/15400-pilonidal-disease

  A pilonidal cyst is usually caused by a skin infection. […] These cysts are usually caused by a skin infection and they often have ingrown hairs inside. […] Experts dont yet know all the causes of pilonidal cysts. However, they do know that ingrown hairs found in the crease of the buttocks result in a skin infection that causes a pilonidal cyst to form. […] Currently, many researchers believe that pilonidal cysts are caused by ingrown hairs.

• #20 Pilonidal Disease | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/pilonidal-disease

  Pilonidal disease is caused by plugged hair follicles in the crease between the buttocks. Any type of hair can cause problems, but the most troublesome is coarse, thick hair. The plugged follicles may rupture into the deeper skin, creating an indentation, or pit, in the skin. If irritation under the skin continues, a pilonidal sinus, or tract, may form. This allows hair and other debris to travel under the skin and form a nest (a nidus), usually above the pit. This collection of hair and debris can get infected and an abscess may form. In severe pilonidals it is not unusual to have more than one abscess. […] Factors that increase the risk of the follicles becoming plugged and rupturing include: Family history of pilonidal disease, Sitting for a long time, Activities such as horseback riding or bicycling that put extended pressure on the area, Thick or coarse body hair, Tight clothing, Excess weight, Tendency to sweat heavily.

• #21 Pilonidal disease

  https://dermnetnz.org/topics/pilonidal-disease

  Pilonidal disease is a chronic skin problem found most often in the sacrococcygeal region. […] The exact reason why pilonidal disease occurs is still unclear. Possible causes include: […] Some people are born with small holes or pits near the base of the spine. These are in fact enlarged hair follicles. […] Follicular occlusion; some people are genetically prone to this. They may also suffer from hidradenitis suppurativa, acne conglobata, and dissecting cellulitis (follicular occlusion syndrome or tetrad). […] When subjected to friction and motion, the follicles 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.

• #22 What Causes Pilonidal Cysts: Determining Your Risk Factor — Colorectal Clinic of Tampa Bay

  https://www.tampacolorectal.com/blog/what-causes-pilonidal-cysts-determining-your-risk-factor

  Pilonidal cysts are most often caused by ingrown hairs or skin debris, but you may also develop these types of cysts if you experience blunt force trauma to that region. […] A few other potential causes of pilonidal cysts are: Frequent bicycling. […] Friction or pressure in the area. […] Tight clothing. […] The risk factors of pilonidal cysts include people who sit for long periods, such as truck drivers and desk workers. […] These cysts also occur more often in young men (younger than 20). […] Obesity and an inactive lifestyle are additional risk factors, and those with excessive body hair or coarse hair may also be at a higher risk for pilonidal cysts.

• #23 Pilonidal Disease | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/pilonidal-disease

  Pilonidal disease is caused by plugged hair follicles in the crease between the buttocks. Any type of hair can cause problems, but the most troublesome is coarse, thick hair. The plugged follicles may rupture into the deeper skin, creating an indentation, or pit, in the skin. If irritation under the skin continues, a pilonidal sinus, or tract, may form. This allows hair and other debris to travel under the skin and form a nest (a nidus), usually above the pit. This collection of hair and debris can get infected and an abscess may form. In severe pilonidals it is not unusual to have more than one abscess. […] Factors that increase the risk of the follicles becoming plugged and rupturing include: Family history of pilonidal disease, Sitting for a long time, Activities such as horseback riding or bicycling that put extended pressure on the area, Thick or coarse body hair, Tight clothing, Excess weight, Tendency to sweat heavily.

• #24 Pilonidal Cyst | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/pilonidal-cyst

  The cause of pilonidal cysts has been debated since they were first recognized. Most likely, the cause may be a combination of: […] Injury to the area. Injury, rubbing, or skin irritation may cause pilonidal cysts. This can happen from sitting for long periods of time. It can be more common in people who sit or drive a lot for work. […] These cysts can affect anyone. But they’re more common in males, especially those with a large amount of body hair.

• #25 Pilonidal Cyst: Symptoms, Causes, & Treatment

  https://www.webmd.com/skin-problems-and-treatments/pilondial-cyst

  Pilonidal cysts can be treated. If your cyst becomes a problem, your doctor can drain it or take it out through surgery. […] Researchers think that ingrown hairs cause pilonidal cysts. Pilonidal means „nest of hair,” and doctors sometimes find hair follicles inside the cyst. […] During World War II, more than 80,000 soldiers got pilonidal cysts that put them in the hospital. People thought they were because of irritation from riding in bumpy Jeeps. For a while, the condition was called „Jeep disease.” […] You might be more likely to get one if you were born with a small dimple in the skin between your buttocks, called a sacral dimple. This harmless dimple could get infected and result in a pilonidal cyst, though doctors aren’t exactly sure why. […] It’s possible to inherit a pilonidal cyst from a relative. For example, if thick, coarse body hair runs in your family, you are more likely to get a cyst.

• #26 What Is Pilonidal Cyst? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/pilonidal-cyst/guide/

  A pilonidal cyst forms when loose hairs get trapped under the skin above the tailbone. It can result in pus accumulation, pain, and skin irritation. […] Experts don’t agree on exactly what causes pilonidal cysts. If you sit for prolonged periods or wear tight clothing, you may be at higher risk of getting these cysts. […] Some believe ingrown hairs (loose hairs that reenter the skin) are triggers. The skin then responds to the hair as if it were a foreign body and forms a cyst around it. […] According to another theory, as deep layers of the skin stretch, the hair follicle enlarges and ruptures, and then a cyst forms around the follicle that ruptures. […] Some experts believe pilonidal cysts occur after trauma to that body area. […] Many World War II soldiers, for example, had pilonidal cysts. Experts blamed those cysts on the chronic irritation that occurred when the soldiers rode in jeeps over bumpy terrain.

• #27 Pilonidal Cyst and Sinus Clinical Presentation: History, Physical, Causes

  https://emedicine.medscape.com/article/788127-clinical

  Pilonidal disease is acquired, not congenital, and involves loose hair and skin and perineal flora. […] Risk factors for pilonidal disease include male gender, hirsute individuals, Caucasians, sitting occupations, existence of a deep natal cleft, and presence of hair within the natal cleft. Family history is seen in 38% of patients with pilonidal disease. Obesity is a risk factor for recurrent disease. […] The most commonly reported bacteria cultured from pilonidal abscesses differ by study. In one study, anaerobic cocci were present 77% of the time; aerobic, 4%; and mixed aerobic and anaerobic, 17%. Other studies quote Staphylococcus aureus, an aerobe, as being the most common bacterial pathogen.

• #28 Pilonidal Cyst and Sinus Clinical Presentation: History, Physical, Causes

  https://emedicine.medscape.com/article/788127-clinical

  Pilonidal disease is acquired, not congenital, and involves loose hair and skin and perineal flora. […] Risk factors for pilonidal disease include male gender, hirsute individuals, Caucasians, sitting occupations, existence of a deep natal cleft, and presence of hair within the natal cleft. Family history is seen in 38% of patients with pilonidal disease. Obesity is a risk factor for recurrent disease. […] The most commonly reported bacteria cultured from pilonidal abscesses differ by study. In one study, anaerobic cocci were present 77% of the time; aerobic, 4%; and mixed aerobic and anaerobic, 17%. Other studies quote Staphylococcus aureus, an aerobe, as being the most common bacterial pathogen.

• #29 Pilonidal disease

  https://dermnetnz.org/topics/pilonidal-disease

  Pilonidal disease is a chronic skin problem found most often in the sacrococcygeal region. […] The exact reason why pilonidal disease occurs is still unclear. Possible causes include: […] Some people are born with small holes or pits near the base of the spine. These are in fact enlarged hair follicles. […] Follicular occlusion; some people are genetically prone to this. They may also suffer from hidradenitis suppurativa, acne conglobata, and dissecting cellulitis (follicular occlusion syndrome or tetrad). […] When subjected to friction and motion, the follicles 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.

• #30 Pilonidal disease

  https://dermnetnz.org/topics/pilonidal-disease

  Pilonidal disease is a chronic skin problem found most often in the sacrococcygeal region. […] The exact reason why pilonidal disease occurs is still unclear. Possible causes include: […] Some people are born with small holes or pits near the base of the spine. These are in fact enlarged hair follicles. […] Follicular occlusion; some people are genetically prone to this. They may also suffer from hidradenitis suppurativa, acne conglobata, and dissecting cellulitis (follicular occlusion syndrome or tetrad). […] When subjected to friction and motion, the follicles 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.

• #31 Pilonidal disease

  https://dermnetnz.org/topics/pilonidal-disease

  Pilonidal disease is a chronic skin problem found most often in the sacrococcygeal region. […] The exact reason why pilonidal disease occurs is still unclear. Possible causes include: […] Some people are born with small holes or pits near the base of the spine. These are in fact enlarged hair follicles. […] Follicular occlusion; some people are genetically prone to this. They may also suffer from hidradenitis suppurativa, acne conglobata, and dissecting cellulitis (follicular occlusion syndrome or tetrad). […] When subjected to friction and motion, the follicles 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.

• #32 Pilonidal disease

  https://dermnetnz.org/topics/pilonidal-disease

  Pilonidal disease is a chronic skin problem found most often in the sacrococcygeal region. […] The exact reason why pilonidal disease occurs is still unclear. Possible causes include: […] Some people are born with small holes or pits near the base of the spine. These are in fact enlarged hair follicles. […] Follicular occlusion; some people are genetically prone to this. They may also suffer from hidradenitis suppurativa, acne conglobata, and dissecting cellulitis (follicular occlusion syndrome or tetrad). […] When subjected to friction and motion, the follicles 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.

• #33 Rethinking the causes of pilonidal sinus disease: a matched cohort study | Scientific Reports

  https://www.nature.com/articles/s41598-021-85830-1

  Our understanding of pilonidal sinus disease (PSD) is based on a paper published 29 years ago by Karydakis. Since then, surgeons have been taught that hair more easily penetrates wet skin, leading to the assumption that sweating promotes PSD. This postulate, however, has never been proven. […] In the past nineteen decades, allegedly insufficient hygiene, sweating as such, and sweating due to obesity have been blamed for more frequent PSD teaching points which are routinely covered in classic educational manuscripts globally. While poor hygiene has been disproven as a cause in the military population and in the civilian population, obesity and sweating remain assumed risk factors, and globally it is taught that they cause PSD. […] For decades surgeons have assumed that maceration of the IGF is a risk factor for PSD and that pilonidal patients sweat more than people without the disease. Our analysis adjusting for confounding disproves this. We proved that sweat production in the lumbar area is significantly lower in PSD patients than in controls, leading us to reject our alternative hypothesis. Thus our findings overturn long-standing assumptions about the genesis of PSD.

• #34 Rethinking the causes of pilonidal sinus disease: a matched cohort study | Scientific Reports

  https://www.nature.com/articles/s41598-021-85830-1

  Our findings present a different picture of pilonidal disease than the one provided by Karydakis. Pilonidal patients don’t sweat more than their gender-, age-, BMI- and exercise-matched controls, and the alternative hypothesis that pilonidal patients sweat significantly more in the lumbar region should be rejected.

• #35 Rethinking the causes of pilonidal sinus disease: a matched cohort study | Scientific Reports

  https://www.nature.com/articles/s41598-021-85830-1

  Our understanding of pilonidal sinus disease (PSD) is based on a paper published 29 years ago by Karydakis. Since then, surgeons have been taught that hair more easily penetrates wet skin, leading to the assumption that sweating promotes PSD. This postulate, however, has never been proven. […] In the past nineteen decades, allegedly insufficient hygiene, sweating as such, and sweating due to obesity have been blamed for more frequent PSD teaching points which are routinely covered in classic educational manuscripts globally. While poor hygiene has been disproven as a cause in the military population and in the civilian population, obesity and sweating remain assumed risk factors, and globally it is taught that they cause PSD. […] For decades surgeons have assumed that maceration of the IGF is a risk factor for PSD and that pilonidal patients sweat more than people without the disease. Our analysis adjusting for confounding disproves this. We proved that sweat production in the lumbar area is significantly lower in PSD patients than in controls, leading us to reject our alternative hypothesis. Thus our findings overturn long-standing assumptions about the genesis of PSD.

• #36 Rethinking the causes of pilonidal sinus disease: a matched cohort study | Scientific Reports

  https://www.nature.com/articles/s41598-021-85830-1

  Our findings present a different picture of pilonidal disease than the one provided by Karydakis. Pilonidal patients don’t sweat more than their gender-, age-, BMI- and exercise-matched controls, and the alternative hypothesis that pilonidal patients sweat significantly more in the lumbar region should be rejected.

• #37 Pilonidal cyst – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pilonidal-cyst/symptoms-causes/syc-20376329

  A pilonidal cyst is an unusual pocket in the skin that usually contains hair and skin debris. […] Pilonidal cysts usually occur when hair punctures the skin and then becomes embedded. […] The cause of most pilonidal cysts is loose hairs that puncture the skin. Friction and pressure from rubbed skin, tight clothing, cycling or long periods of sitting can force hair into the skin. […] The body creates a cyst around the hair to try to push it out. Most pilonidal cysts form on the tailbone. People who groom animals or cut hair can develop a cyst between their fingers.

• #38 Pilonidal Cysts and Sinuses | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/pilonidal-sinus-and-cysts

  Pilonidal cysts and sinuses are a spectrum of pilonidal disease conditions that occur between the buttocks (gluteal crease or cleft) near the tailbone in the lower back. […] Typically, pilonidal cysts occur after puberty and are more common among young men and teen boys than their female counterparts. […] The shape of the area between the buttocks and beneath the small of the back lends itself to the development of pilonidal disease. With the combination of body hair, hormones, hygiene, and other unknown factors that occur after puberty, pilonidal cysts can form, and pilonidal disease can occur. […] Although hair within the gluteal crease is likely a major factor causing pilonidal cysts and sinuses, no single cause can be used to explain the full spectrum of disease. […] When there is ongoing irritation under the skin in this area, a pilonidal tract (small opening in the skin) can form, allowing additional hair, oil and debris to travel under the skin. This collection of hair, oil and debris can get trapped under the skin, become infected and form an abscess or abnormal bump on the skins surface.

• #39 What is a pilonidal cyst? What are the causes? – Szpital Medfemina | Wrocław

  https://hospital.medfemina.com/what-is-a-pilonidal-cyst-what-are-the-causes/

  A pilonidal cyst, also known as pilonidal disease, is a chronic inflammation between the cheeks of the buttocks. […] We do not know exactly what causes the disease. The most likely cause is hairs ingrowing into the skin, which leads to the inflammation of the subcutaneous tissue and micro-abscesses. […] Specific conditions which naturally occur in the buttocks area (warmth, humidity, poor air access, anaerobic bacteria, cheek friction) may contribute to the inflammation. […] There are also a number of risk factors for a pilonidal cyst, such as: being male, genetic predisposition to acne, boils, inflammation of hair follicles and sebaceous cysts, having thick stiff hair on the buttocks, injury to the tailbone, sitting for long periods of time (at work, riding a bike or a horse, driving a car), obesity, smoking, diabetes.

• #40 Pilonidal Sinus Disease (Pilonidal Cyst) – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/pilonidal-sinus-disease-pilonidal-cyst/

  Gravity and the morphological shape of the pelvis and buttocks also play a significant role in the development of PSD. […] It has been suggested that gravity and intergluteal motion together create a type of vacuum that directs loose hair into the funnel of the pilonidal sinus. […] It is only those men and women who have a predisposing morphologic shape and curvature of their buttocks and who routinely create rhythmical, shearing movements with their lower backs and buttocks in their occupation and normal daily activities who will develop PSD.

• #41 Pilonidal Sinus Disease (Pilonidal Cyst) – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/pilonidal-sinus-disease-pilonidal-cyst/

  Gravity and the morphological shape of the pelvis and buttocks also play a significant role in the development of PSD. […] It has been suggested that gravity and intergluteal motion together create a type of vacuum that directs loose hair into the funnel of the pilonidal sinus. […] It is only those men and women who have a predisposing morphologic shape and curvature of their buttocks and who routinely create rhythmical, shearing movements with their lower backs and buttocks in their occupation and normal daily activities who will develop PSD.

• #42 Pilonidal Sinus Disease (Pilonidal Cyst) – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/pilonidal-sinus-disease-pilonidal-cyst/

  Gravity and the morphological shape of the pelvis and buttocks also play a significant role in the development of PSD. […] It has been suggested that gravity and intergluteal motion together create a type of vacuum that directs loose hair into the funnel of the pilonidal sinus. […] It is only those men and women who have a predisposing morphologic shape and curvature of their buttocks and who routinely create rhythmical, shearing movements with their lower backs and buttocks in their occupation and normal daily activities who will develop PSD.

• #43 Pilonidal Sinus Disease (Pilonidal Cyst) – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/pilonidal-sinus-disease-pilonidal-cyst/

  Gravity and the morphological shape of the pelvis and buttocks also play a significant role in the development of PSD. […] It has been suggested that gravity and intergluteal motion together create a type of vacuum that directs loose hair into the funnel of the pilonidal sinus. […] It is only those men and women who have a predisposing morphologic shape and curvature of their buttocks and who routinely create rhythmical, shearing movements with their lower backs and buttocks in their occupation and normal daily activities who will develop PSD.

• #44 How to Prevent a Pilonidal Cyst from Coming Back: Surgical Associates of North Texas: Advanced Laparoscopic Surgeons

  https://www.surgicalassociatesofnorthtexas.com/blog/how-to-prevent-a-pilonidal-cyst-from-coming-back

  Your chances of having pilonidal cysts also increase if youve had them in the past. […] Getting expert treatment for your pilonidal cyst is just the first step to preventing recurring problems. Dr. deVilleneuve could also recommend: Losing weight, if needed, Avoiding long periods of sitting, Keeping the area cleansed and dry. […] You can also reduce your chances of developing chronic pilonidal cysts by removing hair from the area with shaving, waxing, or other products.

• #45 How to Prevent a Pilonidal Cyst from Coming Back: Surgical Associates of North Texas: Advanced Laparoscopic Surgeons

  https://www.surgicalassociatesofnorthtexas.com/blog/how-to-prevent-a-pilonidal-cyst-from-coming-back

  Your chances of having pilonidal cysts also increase if youve had them in the past. […] Getting expert treatment for your pilonidal cyst is just the first step to preventing recurring problems. Dr. deVilleneuve could also recommend: Losing weight, if needed, Avoiding long periods of sitting, Keeping the area cleansed and dry. […] You can also reduce your chances of developing chronic pilonidal cysts by removing hair from the area with shaving, waxing, or other products.

• #46 Pilonidal cyst: Symptoms, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/317996

  Pilonidal cysts typically develop above the cleft of the buttocks. These swollen lumps contain hair or other debris. They occur when small holes in the skin, known as pilonidal sinuses, become infected. […] At present, the exact reason why pilonidal cysts develop is unclear. […] An abundance of hair in the buttock region may also increase a persons risk of developing the condition the word pilonidal means nest of hair. […] Another possible cause of a pilonidal cyst is the result of applying force or friction to the area. […] Pilonidal cysts occur when a pilonidal sinus, a small hole or indentation in the skin, becomes infected. This typically happens when hair or other debris fills the sinus. […] People can help prevent pilonidal cysts by keeping the area around their buttocks clean and dry. Removing body hair through shaving or creams can also help.

• #47 How to Prevent a Pilonidal Cyst from Coming Back: Surgical Associates of North Texas: Advanced Laparoscopic Surgeons

  https://www.surgicalassociatesofnorthtexas.com/blog/how-to-prevent-a-pilonidal-cyst-from-coming-back

  Your chances of having pilonidal cysts also increase if youve had them in the past. […] Getting expert treatment for your pilonidal cyst is just the first step to preventing recurring problems. Dr. deVilleneuve could also recommend: Losing weight, if needed, Avoiding long periods of sitting, Keeping the area cleansed and dry. […] You can also reduce your chances of developing chronic pilonidal cysts by removing hair from the area with shaving, waxing, or other products.

• #48

  https://journals.lww.com/dcrjournal/abstract/2000/43080/pilonidal_cyst__cause_and_treatment.18.aspx

  There is nearly a consensus that pilonidal cyst is acquired, hair being the agent that causes the disease. […] The majority of authors conclude that sacrococcygeal pilonidal cyst is an acquired disease, although a minority believe it is congenital.

• #49 Why is Pilonidal Disease Not a Pilonidal Cyst – Sternberg Clini

  https://pilonidalsurgery.com/pilonidal-disease/why-is-a-pilonidal-cyst-not-really-a-cyst/

  Pilonidal disease (AKA pilonidal cysts) is not congenital, it is an acquired infection involving the skin and underlying tissue of the midline natal (buttock) cleft. […] THE CAUSE OF PILONIDAL DISEASE IS THE DEEP BUTTOCK CLEFT, AND OPERATIONS TO FIX THIS PROBLEM NEED TO MAKE THE CLEFT SHALLOWER! […] People who develop a pilonidal disease are not born with it (congenital theory); they acquire it, likely by repeated microtrauma in someone prone to the condition. […] THEY ARE BORN WITH A DEEP VALLEY/CLEFT BETWEEN THEIR BUTTOCK CHEEKS AND THIS CONGENITAL TRAIT ALLOWS THE CONDITION TO DEVELOP. […] Surgeons who perform operations for pilonidal disease often mistakenly believe it is caused by a congenital cyst. […] OPERATIONS THAT FAIL TO MAKE THE DEEP CLEFT MORE SHALLOW, DONT ELIMINATE EMPY/DEAD SPACE, AND DONT PLACE THE INCISION AWAY FROM THE VULNERABLE MIDLINE (THIS IS WHERE ALL THE TENSION IS) WONT RELIABLY CURE PILONIDAL DISEASE.

• #50 Pilonidal Cyst: Causes, Symptoms, Treatments & Removal

  https://my.clevelandclinic.org/health/diseases/15400-pilonidal-disease

  A pilonidal cyst is usually caused by a skin infection. […] These cysts are usually caused by a skin infection and they often have ingrown hairs inside. […] Experts dont yet know all the causes of pilonidal cysts. However, they do know that ingrown hairs found in the crease of the buttocks result in a skin infection that causes a pilonidal cyst to form. […] Currently, many researchers believe that pilonidal cysts are caused by ingrown hairs.

• #51 Pilonidal disease – Symptoms, Causes, Images, and Treatment Options

  https://www.epocrates.com/online/diseases/1146/pilonidal-disease

  Pilonidal disease is a chronic, suppurative condition most commonly involving the natal cleft that typically affects young men. […] It is an acquired disease in which loose hairs trapped within the natal cleft penetrate the skin leading to a granulomatous foreign body reaction. As a result, midline pits within the natal cleft and chronic sinus tracts may develop. […] Pilonidal disease may be asymptomatic or present with an acute abscess or a chronic cyst and/or sinus with persistent drainage.

• #52 Why is Pilonidal Disease Not a Pilonidal Cyst – Sternberg Clini

  https://pilonidalsurgery.com/pilonidal-disease/why-is-a-pilonidal-cyst-not-really-a-cyst/

  Pilonidal disease (AKA pilonidal cysts) is not congenital, it is an acquired infection involving the skin and underlying tissue of the midline natal (buttock) cleft. […] THE CAUSE OF PILONIDAL DISEASE IS THE DEEP BUTTOCK CLEFT, AND OPERATIONS TO FIX THIS PROBLEM NEED TO MAKE THE CLEFT SHALLOWER! […] People who develop a pilonidal disease are not born with it (congenital theory); they acquire it, likely by repeated microtrauma in someone prone to the condition. […] THEY ARE BORN WITH A DEEP VALLEY/CLEFT BETWEEN THEIR BUTTOCK CHEEKS AND THIS CONGENITAL TRAIT ALLOWS THE CONDITION TO DEVELOP. […] Surgeons who perform operations for pilonidal disease often mistakenly believe it is caused by a congenital cyst. […] OPERATIONS THAT FAIL TO MAKE THE DEEP CLEFT MORE SHALLOW, DONT ELIMINATE EMPY/DEAD SPACE, AND DONT PLACE THE INCISION AWAY FROM THE VULNERABLE MIDLINE (THIS IS WHERE ALL THE TENSION IS) WONT RELIABLY CURE PILONIDAL DISEASE.

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