Materiały źródłowe

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

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

  Pilonidal disease was first reported in 1833. […] In the 1950s, pilonidal sinus disease was thought to be of congenital origin rather than an acquired disorder. […] 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 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. […] Since then, however, theories have come to focus primarily on predisposing factors and acquired conditions. […] The incidence of pilonidal disease is also affected by hair characteristics, such as kinking, medullation, coarseness, and growth rate.

• #2

  https://journals.lww.com/dcrjournal/abstract/1962/05010/the_etiology_of_pilonidal_sinus.5.aspx

  The gross and microscopic pathologic findings in our 354 patients overwhelmingly favor the theory of acquired origin in most patients with pilonidal sinus. […] A new classification of pilonidal disease based on etiology is proposed as a result of this study. In this classification the disease is divided into two groups: (1) congenital, and (2) acquired. […] Neurogenic and ectodermal pilonidal sinuses are relatively uncommon, probably less than 10 per cent of the total, whereas the acquired variety of post-traumatic and postsurgical lesions constitute 90 per cent of the cases.

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

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

  Pilonidal disease was first reported in 1833. […] In the 1950s, pilonidal sinus disease was thought to be of congenital origin rather than an acquired disorder. […] 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 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. […] Since then, however, theories have come to focus primarily on predisposing factors and acquired conditions. […] The incidence of pilonidal disease is also affected by hair characteristics, such as kinking, medullation, coarseness, and growth rate.

• #4 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.

• #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 Sacrococcygeal pilonidal sinus: historical review, pathological insight and surgical options – PubMed

  https://pubmed.ncbi.nlm.nih.gov/12750948/

  Sacrococcygeal pilonidal disease is a common and well recognized entity. For many years the cause of sacrococcygeal pilonidal sinus has been matter of debate. […] In dealing with the pathogenesis of pilonidal sinus disease, Karydakis attributed the hair insertion process to three main factors: the invader, i.e. the loose hair; the force, which causes the insertion; and the vulnerability of the skin to the insertion of hair at the depth of the natal cleft.

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

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

  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

  https://www.nhs.uk/conditions/pilonidal-sinus/

  A pilonidal sinus is a small hole or tunnel at the top of your bottom, between your buttocks. […] It’s not clear what causes a pilonidal sinus. A skin problem, pressure or friction may cause hair between the buttocks to be pushed inwards. This may either be hair growing around the buttock area, or loose hair shed from the buttocks or elsewhere that gathers around the buttock cleft and enters the pilonidal sinus. Pilonidal sinuses are more common in men because they tend to be hairier. Sitting for long periods can also increase your chances of getting a pilonidal sinus.

• #10 Pilonidal sinus

  https://www2.hse.ie/conditions/pilonidal-sinus/

  It’s not clear what causes a pilonidal sinus. […] A skin problem, pressure or friction may cause hair between the buttocks to be pushed inwards. […] This may be hair growing around the buttock area. it could also be loose hair shed from the buttocks or elsewhere that gathers around the buttock cleft and enters the pilonidal sinus. […] Pilonidal sinuses are more common in men because they tend to be hairier. […] Sitting for long periods can also increase your chances of getting a pilonidal sinus.

• #11 Pilonidal Sinus – USZ

  https://www.usz.ch/en/disease/pilonidal-sinus/

  A pilonidal sinus is an inflammation in the subcutaneous fatty tissue caused by broken hairs that have penetrated the skin. […] Researchers now assume that pilonidal sinus is an acquired disease that only occurs in the course of life. […] The causes of pilonidal sinus are broken hairs that penetrate the skin at the gluteal fold. […] The fact that the horny scales of the hair serve as barbs is conducive to penetration into the subcutaneous fatty tissue. […] The pressure on the skin when sitting and movements ensure that the hair is pushed further and further into the skin and irritates it. […] The skin reacts to the hair as if it were a foreign body and triggers an inflammation. […] A cyst forms around the hair, which contains hair fragments, granulation tissue (formed during wound healing) and dead cell remnants.

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

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

  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.

• #13 Signs of Pilonidal Sinus, the Causes and Treatment

  https://www.dramitajain.com/blog/2024/02/08/signs-pilonidal-sinus-causes-treatment/

  Pilonidal cysts can develop due to a combination of factors, although the precise cause isn’t fully understood. […] One contributing factor is the presence of ingrown hairs in the buttock crease, leading to a skin infection and subsequent cyst formation. […] This condition often arises post-puberty due to hormonal changes, increased hair growth, and the friction generated by activities like prolonged sitting. […] When friction forces hair to penetrate the skin, the body perceives it as a foreign object and triggers an immune response, similar to reacting to a splinter. […] This immune response results in the formation of a cyst around the trapped hair, sometimes leading to the development of multiple sinuses connecting beneath the skin.

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

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

  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 Pilonidal sinus

  https://www.nhs.uk/conditions/pilonidal-sinus/

  A pilonidal sinus is a small hole or tunnel at the top of your bottom, between your buttocks. […] It’s not clear what causes a pilonidal sinus. A skin problem, pressure or friction may cause hair between the buttocks to be pushed inwards. This may either be hair growing around the buttock area, or loose hair shed from the buttocks or elsewhere that gathers around the buttock cleft and enters the pilonidal sinus. Pilonidal sinuses are more common in men because they tend to be hairier. Sitting for long periods can also increase your chances of getting a pilonidal sinus.

• #16 Pilonidal sinus

  https://www2.hse.ie/conditions/pilonidal-sinus/

  It’s not clear what causes a pilonidal sinus. […] A skin problem, pressure or friction may cause hair between the buttocks to be pushed inwards. […] This may be hair growing around the buttock area. it could also be loose hair shed from the buttocks or elsewhere that gathers around the buttock cleft and enters the pilonidal sinus. […] Pilonidal sinuses are more common in men because they tend to be hairier. […] Sitting for long periods can also increase your chances of getting a pilonidal sinus.

• #17 Pilonidal disease – symptoms and treatment | healthdirect

  https://www.healthdirect.gov.au/pilonidal-disease

  Pilonidal disease is an inflammatory skin condition that usually develops in the crease between your buttocks. […] The cause of pilonidal disease is not fully understood. […] Hair often grows in the cleft (crease) between the buttocks. These hairs can enter your skin, causing irritation and inflammation. […] The hair might be forced into your skin by friction and pressure from: tight clothing, cycling, long periods of sitting. […] Pilonidal disease usually affects young people between the ages of 16 and 40 years. It is more common in: males, people with a family history of pilonidal disease, people who have a lot of hair.

• #18 Pilonidal disease | Healthify

  https://healthify.nz/health-a-z/p/pilonidal-sinus

  Pilonidal disease is a condition that occurs at the base of your spine in the gap between the top of your buttocks (your natal cleft). […] It’s not known why pilonidal disease happens, but it may be due to having a small dimple in the area or damaged hair follicles that poke into your skin. Once the hairs become stuck in your skin they irritate it, causing inflammation. A cavity can develop in this area called a pilonidal sinus. […] There are certain situations that make it more likely to happen. These include: having curly or coarse body hair in the area around your buttocks, having a family history of the disease, being overweight, poor hygiene, prolonged sitting or repeated friction to the area causing increased sweating, certain other skin conditions. […] Pilonidal disease can affect anyone but is most common in men. Usually it occurs after puberty and is rare after the age of 40.

• #19 Pilonidal sinus | nidirect

  https://www.nidirect.gov.uk/conditions/pilonidal-sinus

  The exact cause of a pilonidal sinus is unclear, although it’s thought to be caused by loose hair piercing the skin. […] Certain things can increase your chances of developing a pilonidal sinus. […] These include: being overweight, having a large amount of body hair, having a job that involves a lot of sitting or driving.

• #20 Pilonidal sinus disease Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/symptoms/pilonidal-sinus-disease

  Pilonidal sinus disease is an inflammatory condition involving the hair follicles that can occur anywhere along the crease between the buttocks, which runs from the bone at the bottom of the spine (sacrum) to the anus. The cause of pilonidal disease is not clear. It is thought to be caused by hair growing into the skin in the crease between the buttocks. […] This problem is more likely to occur in people who: Are obese, Experience trauma or irritation in the area, Have excess body hair, particularly coarse, curly hair.

• #21 Pilonidal sinus disease Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/symptoms/pilonidal-sinus-disease

  Pilonidal sinus disease is an inflammatory condition involving the hair follicles that can occur anywhere along the crease between the buttocks, which runs from the bone at the bottom of the spine (sacrum) to the anus. The cause of pilonidal disease is not clear. It is thought to be caused by hair growing into the skin in the crease between the buttocks. […] This problem is more likely to occur in people who: Are obese, Experience trauma or irritation in the area, Have excess body hair, particularly coarse, curly hair.

• #22 Pilonidal sinus: Symptoms, pictures, and treatment

  https://www.medicalnewstoday.com/articles/pilonidal-sinus

  According to the American Society of Colon and Rectal Surgeons (ASCRS), the cause of pilonidal sinus is not clear. […] It may be due to hair that grows in the crease of the buttocks, or natal cleft. Alternatively, trapped hair follicles may lead to hair and bacteria entering the skin. This can result in inflammation and pus forming in an abscess. […] Risk factors for pilonidal sinus include: being male, having a family history of pilonidal disease, being overweight, experiencing trauma or irritation in the area, having a sedentary lifestyle or sitting down for long periods, having a lot of hair around the buttocks, practicing poor hygiene habits, being younger, as pilonidal sinus is more common in young adults. […] A pilonidal sinus can return after treatment, but maintaining good hygiene habits and removing hair from the area may help reduce the risk of it returning.

• #23 Pilonidal disease – Wikipedia

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

  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. […] Pilonidal cysts may be caused by a congenital pilonidal dimple. […] 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. The presence of bacteria and low oxygen levels hamper wound healing and exacerbate a developing pilonidal cyst.

• #24 Pilonidal sinus

  https://www2.hse.ie/conditions/pilonidal-sinus/

  It’s not clear what causes a pilonidal sinus. […] A skin problem, pressure or friction may cause hair between the buttocks to be pushed inwards. […] This may be hair growing around the buttock area. it could also be loose hair shed from the buttocks or elsewhere that gathers around the buttock cleft and enters the pilonidal sinus. […] Pilonidal sinuses are more common in men because they tend to be hairier. […] Sitting for long periods can also increase your chances of getting a pilonidal sinus.

• #25 Pilonidal disease – Wikipedia

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

  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. […] Pilonidal cysts may be caused by a congenital pilonidal dimple. […] 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. The presence of bacteria and low oxygen levels hamper wound healing and exacerbate a developing pilonidal cyst.

• #26 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.

• #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 sinus – Causes & treatment | Glasgow Colorectal Centre

  https://www.colorectalcentre.co.uk/pilonidal_sinus.html

  A pilonidal sinus is a small hole leading to a tunnel or tract (sinus) under the skin. […] The exact cause of a pilonidal sinus is unclear, although it’s thought to be caused by loose hair piercing the skin. Certain things can increase your chances of developing a pilonidal sinus, such as being obese, having a large amount of body hair (especially thick stiff body hair), and having a job that involves a lot of sitting or driving. […] The condition is more common if there is repeated trauma to area, especially in the presence of poor hygiene. […] Having a family history of the condition may also be important more than one-third of people have a family member with the condition.

• #29 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.

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

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

  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.

• #31 Pilonidal Sinus: Symptoms, Causes, Diagnosis, Treatment

  https://www.health.com/pilonidal-sinus-8651656

  Pilonidal sinus also called a pilonidal cyst is a skin infection that occurs in or around the crease of your buttocks. This condition happens when hair, skin cells, and dirt clog a hair follicle, creating a sinus tract (a small tunnel in the skin) that can become infected and turn into a cyst or swollen lump of tissue. […] Its not fully understood why this infection happens more often in some people or why ingrown hairs in the area of the buttocks can cause sinus tracts to form. However, some researchers believe that pilonidal sinus results from a combination of three factors: […] Ingrown hair, An area of vulnerable skin, Some type of pressure that pushes the hair deep enough into the skin to form a sinus tract.

• #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. […] 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. […] Skin and perineal bacteria such as Staphylococcus aureus and Bacteroides species invade the opening and cause infection.

• #33 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.

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

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

  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.

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

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

  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.

• #36 Signs of Pilonidal Sinus, the Causes and Treatment

  https://www.dramitajain.com/blog/2024/02/08/signs-pilonidal-sinus-causes-treatment/

  Pilonidal cysts can develop due to a combination of factors, although the precise cause isn’t fully understood. […] One contributing factor is the presence of ingrown hairs in the buttock crease, leading to a skin infection and subsequent cyst formation. […] This condition often arises post-puberty due to hormonal changes, increased hair growth, and the friction generated by activities like prolonged sitting. […] When friction forces hair to penetrate the skin, the body perceives it as a foreign object and triggers an immune response, similar to reacting to a splinter. […] This immune response results in the formation of a cyst around the trapped hair, sometimes leading to the development of multiple sinuses connecting beneath the skin.

• #37 Pilonidal Sinus: Symptoms, Causes, Diagnosis and Treatment

  https://www.miracleshealth.com/blog/pilonidal-sinus-symptoms-causes-diagnosis-and-treatment

  Pilonidal sinus might sound complex. To manage it effectively, it is important to know the basics. […] The exact causes of pilonidal sinuses are unknown, but there are a combination of factors, including: […] Hormonal changes: Pilonidal sinuses are more common in young adults. It is believed that it can occur due to hormonal changes during puberty. […] Family history: If you have a family history of the pilonidal sinus, then you may be at increased risk of developing it. […] Ingrown hairs: The ingrown(loose) hairs can puncture the skin. These hairs become embedded and trigger an inflammatory response. […] Friction and pressure: Prolonged sitting or wearing tight clothing can rub the skin together. It creates friction and pushes hair into the skin.

• #38 Pilonidal Disease: Causes, Risk Factors, Symptoms and Treatment | Nationwide Children’s Hospital

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

  The cause of pilonidal disease is not clear. Loose hairs pushing into the skin may cause the disease. Small holes that hold each hair in the skin are called hair follicles. Pressure and friction on follicles can make them move. This causes hair to grow into the skin (ingrown hair). This is more common after puberty, when hair grows more and skin makes more oils. […] Pilonidal disease is more common in patients born male between 13 and 26 years old. You’re more at risk if: […] You have poor hygiene. […] You are overweight. […] There is a lot of hair around the sinus, or the hair is coarse or curly. […] You had an injury to the affected area before.

• #39 Top 10 Causes of Pilonidal Sinus Treatment | Freefrompiles

  https://www.freefrompiles.com/health-tips/causes-of-pilonidal-sinus-treatment/

  Pilonidal Sinus is a condition that can cause considerable discomfort and impact daily life if not addressed promptly. […] Many people are unaware of its causes, which could help them take preventive measures. […] Pilonidal Sinus Treatment addresses a condition where a cyst or abscess develops near the tailbone, usually caused by ingrown hairs or debris trapped under the skin. […] Ingrown hairs are one of the main reasons for Pilonidal Sinus. Hair strands can penetrate the skin and cause irritation or infection. […] Sitting for long hours, especially on hard surfaces, puts constant pressure on the tailbone area, increasing the chances of developing Pilonidal Sinus. […] Sweat in the lower back region can create a favourable environment for bacterial growth, leading to infection. […] Lack of proper cleaning in the tailbone area can result in trapped dirt and hair, causing infections.

• #40 Medfin BlogWhat is Pilonidal Sinus? Causes and Symptoms – Medfin Blog

  https://www.medfin.in/blog/general-surgeries/what-is-pilonidal-sinus-causes-and-symptoms/

  Pilonidal sinus disease or PNS mostly occurs in men. It is also common in young adults. It usually occurs in people who sit for long hours, such as cab and truck drivers. […] The causes may include a combination of: Changing hormones, Hair growth, Lot of time spent sitting, Friction from clothes. […] Lack of enough exercise, bicycling, poor hygiene and excessive sweating can also be the causative factors for PNS. […] It is possible for this problem to be hereditary. For example, if rough body hair run in your family, then there are more chances for you also to have them, leading to PNS. […] Though it is not contagious, researchers believe it may happen because of ingrown hair.

• #41 Pilonidal Disease: Causes, Risk Factors, Symptoms and Treatment | Nationwide Children’s Hospital

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

  The cause of pilonidal disease is not clear. Loose hairs pushing into the skin may cause the disease. Small holes that hold each hair in the skin are called hair follicles. Pressure and friction on follicles can make them move. This causes hair to grow into the skin (ingrown hair). This is more common after puberty, when hair grows more and skin makes more oils. […] Pilonidal disease is more common in patients born male between 13 and 26 years old. You’re more at risk if: […] You have poor hygiene. […] You are overweight. […] There is a lot of hair around the sinus, or the hair is coarse or curly. […] You had an injury to the affected area before.

• #42 Top 10 Causes of Pilonidal Sinus Treatment | Freefrompiles

  https://www.freefrompiles.com/health-tips/causes-of-pilonidal-sinus-treatment/

  A fall, injury, or repeated pressure on the lower back can damage the skin and underlying tissue, making the area prone to infection. […] Carrying excess weight increases the pressure on the tailbone area, which can aggravate symptoms or lead to the development of Pilonidal Sinus. […] Having a family history of Pilonidal Sinus increases the likelihood of developing the condition. […] Individuals with dense or coarse body hair are more susceptible to Pilonidal Sinus as loose hairs can easily become embedded in the skin. […] Tight clothing around the lower back can cause irritation and increase friction, making the area vulnerable to infection. […] Once you’ve had a Pilonidal Sinus, the risk of recurrence increases without proper aftercare.

• #43 Top 10 Causes of Pilonidal Sinus Treatment | Freefrompiles

  https://www.freefrompiles.com/health-tips/causes-of-pilonidal-sinus-treatment/

  Pilonidal Sinus is a condition that can cause considerable discomfort and impact daily life if not addressed promptly. […] Many people are unaware of its causes, which could help them take preventive measures. […] Pilonidal Sinus Treatment addresses a condition where a cyst or abscess develops near the tailbone, usually caused by ingrown hairs or debris trapped under the skin. […] Ingrown hairs are one of the main reasons for Pilonidal Sinus. Hair strands can penetrate the skin and cause irritation or infection. […] Sitting for long hours, especially on hard surfaces, puts constant pressure on the tailbone area, increasing the chances of developing Pilonidal Sinus. […] Sweat in the lower back region can create a favourable environment for bacterial growth, leading to infection. […] Lack of proper cleaning in the tailbone area can result in trapped dirt and hair, causing infections.

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

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

  Pilonidal cysts can be caused by ingrown hairs. 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. […] Researchers don’t know every cause of a pilonidal cyst, but often it happens when an ingrown hair causes a skin infection and cyst to form. If you are a man, are 20-35 years old, or have thick and coarse hair, you are at increased risk of a pilonidal cyst. Also, if you sit a great deal for work or are overweight, you have a greater risk of developing a cyst.

• #45 Pilonidal disease practice points: An update

  https://www1.racgp.org.au/ajgp/2019/march/pilonidal-disease-practice-points

  Pilonidal disease is an inflammatory condition that typically affects the sacrococcygeal fold. […] The aetiology of pilonidal sinus is still a matter of controversy, but the three most widely accepted theories include the foreign body response theory as outlined by Karydakis, the Bascom hypothesis of midline pits and the Stelzner theory of retention dermatopathy. […] The common point shared by these theories is that chronic retention of keratin/debris in the natal cleft and its associated inflammatory response cause pilonidal disease. […] Over time, this results in a pattern of waxing and waning inflammation.

• #46 Pilonidal disease practice points: An update

  https://www1.racgp.org.au/ajgp/2019/march/pilonidal-disease-practice-points

  Pilonidal disease is an inflammatory condition that typically affects the sacrococcygeal fold. […] The aetiology of pilonidal sinus is still a matter of controversy, but the three most widely accepted theories include the foreign body response theory as outlined by Karydakis, the Bascom hypothesis of midline pits and the Stelzner theory of retention dermatopathy. […] The common point shared by these theories is that chronic retention of keratin/debris in the natal cleft and its associated inflammatory response cause pilonidal disease. […] Over time, this results in a pattern of waxing and waning inflammation.

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

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

  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.

• #48 Approach to Interdigital Pilonidal Sinus: Our Clinical Experience and Literature Review | ClinMed International Library | International Journal of Surgery Research and Practice

  https://www.clinmedjournals.org/articles/ijsrp/international-journal-of-surgery-research-and-practice-ijsrp-3-042.php?jid=ijsrp

  Interdigital pilonidal sinus disease, also called „barber’s disease,” is an acquired occupational disease. […] Although the etiology has not been fully clarified, the disease is thought to be mostly caused by the formation of an acute and chronic infection focus under the skin by hair shed from the skin. […] The theory on the congenital origin of disease was considered until 1946 but was disproved by Patey and Scarff because of the infrequency of pilonidal disease in children. […] IPSD is now generally accepted as an acquired disease independent of body location. […] In addition, IPSD is known as an occupational disease among barbers because the sinuses develop a foreign body reaction against customers’ hair. […] The disease is initiated by short, thick, and sharp hair penetrating the skin of the interdigital sulcus.

• #49 Pilonidal sinus of the cheek: an extremely rare clinical entity—case report and brief review of the literature | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-020-02561-z

  Pilonidal sinus (PNS) refers to a subcutaneous sinus which contains hair. It is an acquired condition caused by penetration of hair fragments into the skin. This hair containing cavity usually is asymptomatic and the only sign of its presence may be a small pit on the surface of the skin. […] The etiology of pilonidal sinus remains unclear. There are two main theories regarding its etiology acquired and congenital. In general, at least three conditions need to be fulfilled for a pilonidal sinus to occur: first is hair in the skin and, second, some kind of wrinkled skin, such as the natal cleft or a scar. The third condition is a mixture of hormonal and hygienic problem. […] For PNS of the cheek to occur, repeated mechanical trauma from shaving coupled with contributions from high testosterone level, repeated folliculitis and intrusion of hair fragment through the damaged overlying skin seems to play the major contributory role. […] Although PNS is very rare in the cheek bulge, it should be included in the differential diagnosis of subcutaneous nodule and chronic sinus when hair is seen inside the cyst cavity or when there is history of some surgical intervention.

• #50 Pilonidal sinus disease

  http://www.worldwidewounds.com/2003/december/Miller/Pilonidal-Sinus.html

  Hair acts as a foreign body causing an inflammatory reaction and can lead to prolonged inflammation and the development of chronic pilonidal disease. […] The combination of a deep abscess cavity with surrounding moist conditions and abundant bacteria, hair, debris and friction cause recurrent infection, associated with chronic pain and discharge. […] Malignant change is a relatively rare complication of pilonidal disease, but evidence of at least 50 such cases is available in published medical literature. The most common scenario is of squamous cell carcinoma arising after decades of antecedent pilonidal disease. […] Recurrence can be divided into two groups: early and late. Early recurrence is usually due to failure to identify one or more sinuses at incision and drainage, which was not followed by a second-look procedure. Late recurrence is usually due to secondary infection caused by residual hair or debris that was not removed at operation, inadequate wound care or insufficient attention to depilation.

• #51 Can You Get Cancer From Pilonidal Sinus?

  https://www.pristyncare.com/blog/cancer-from-pilonidal-sinus-pc0441/

  Pilonidal sinus is a common condition that is found more in young men than women. […] Usually, the pilonidal disease is associated with the development of an infected cyst or abscess formation. […] There are high chances of the skin affected with pilonidal cyst catching inflammation in the long run. Even in the cases where a person undergoes the surgery for pilonidal sinus and still pilonidal sinus disease recurs, it makes the affected skin more prone to inflammation. The prolonged inflammation due to pilonidal sinus acts as a major risk factor for developing skin cancer. This type of skin cancer arising due to pilonidal sinus is called squamous cell carcinoma. […] A study reports a total of 69 cases of skin cancer due to pilonidal sinus since 1900. Doctors are of the opinion that recurring or long-standing problems of pilonidal sinus are the factors contributing to this serious complication. […] The repeated inflammation of the skin causes abnormal changes in its repair mechanism, hence leading to malignant changes. […] Early treatment of pilonidal sinus can save you from dreadful complications like cancer.

• #52 Pilonidal sinus disease

  http://www.worldwidewounds.com/2003/december/Miller/Pilonidal-Sinus.html

  Hair acts as a foreign body causing an inflammatory reaction and can lead to prolonged inflammation and the development of chronic pilonidal disease. […] The combination of a deep abscess cavity with surrounding moist conditions and abundant bacteria, hair, debris and friction cause recurrent infection, associated with chronic pain and discharge. […] Malignant change is a relatively rare complication of pilonidal disease, but evidence of at least 50 such cases is available in published medical literature. The most common scenario is of squamous cell carcinoma arising after decades of antecedent pilonidal disease. […] Recurrence can be divided into two groups: early and late. Early recurrence is usually due to failure to identify one or more sinuses at incision and drainage, which was not followed by a second-look procedure. Late recurrence is usually due to secondary infection caused by residual hair or debris that was not removed at operation, inadequate wound care or insufficient attention to depilation.

• #53 Pilonidal sinus: Symptoms, pictures, and treatment

  https://www.medicalnewstoday.com/articles/pilonidal-sinus

  According to the American Society of Colon and Rectal Surgeons (ASCRS), the cause of pilonidal sinus is not clear. […] It may be due to hair that grows in the crease of the buttocks, or natal cleft. Alternatively, trapped hair follicles may lead to hair and bacteria entering the skin. This can result in inflammation and pus forming in an abscess. […] Risk factors for pilonidal sinus include: being male, having a family history of pilonidal disease, being overweight, experiencing trauma or irritation in the area, having a sedentary lifestyle or sitting down for long periods, having a lot of hair around the buttocks, practicing poor hygiene habits, being younger, as pilonidal sinus is more common in young adults. […] A pilonidal sinus can return after treatment, but maintaining good hygiene habits and removing hair from the area may help reduce the risk of it returning.

• #54 Top 8 Facts About Pilonidal Disease? | Advanced Surgical Physicians

  https://www.toplinemd.com/advanced-surgical-physicians/blog/top-8-facts-about-pilonidal-disease/

  Those with more weight often find that their skin overlaps, causing the pilonidal sinus to occur. Losing weight will ensure that there will be a much lower chance of this disease arising. […] Another way to prevent pilonidal sinus is by not sitting down for long periods. As the skin tends to fold when sitting down, this creates the perfect environment for this disease to flourish. […] If so, we propose that routinely shaving or removing hair in that area. Hair removal will go a long way in ensuring it doesn’t appear again.

• #55 Paediatric Endoscopic Pilonidal Sinus Treatment (PEPSiT) in young people – information for teenagers | CUH

  https://www.cuh.nhs.uk/patient-information/paediatric-endoscopic-pilonidal-sinus-treatment-pepsit-in-young-people-information-for-teenagers/

  The cause of pilonidal sinuses is not known but it results from hairs growing between the buttocks or loose hairs gathering in the groove which separates the buttocks (called the natal cleft) being pushed inwards into the skin and forming a tunnel where increasing numbers of hairs get trapped. This causes an infection. […] Pilonidal sinus most commonly occur in teenagers who have had other family members who have also had this problem, those with a lot of body hair or those who are overweight. […] There is a small (10% risk) that the pilonidal sinus and symptoms can come back after surgery. We advise long term hair removal to minimise this risk.

• #56 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.

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

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

  Although sweat does not harm the skin per se, it can promote a moist environment and enable adhesion of short cut hairs in the IGF, leading to longer contact times and higher injection rates, thereby coinciding with higher incidence of PSD. […] If the IGF were totally dry, no hair would be retained by adhesion. Copious sweating would tend to wash the loose hair fragments downwards, keeping exposure time short. However, we did not see any of these effects in our German PSD cohort. […] 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.

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

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

  Although sweat does not harm the skin per se, it can promote a moist environment and enable adhesion of short cut hairs in the IGF, leading to longer contact times and higher injection rates, thereby coinciding with higher incidence of PSD. […] If the IGF were totally dry, no hair would be retained by adhesion. Copious sweating would tend to wash the loose hair fragments downwards, keeping exposure time short. However, we did not see any of these effects in our German PSD cohort. […] 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.

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

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

  Although sweat does not harm the skin per se, it can promote a moist environment and enable adhesion of short cut hairs in the IGF, leading to longer contact times and higher injection rates, thereby coinciding with higher incidence of PSD. […] If the IGF were totally dry, no hair would be retained by adhesion. Copious sweating would tend to wash the loose hair fragments downwards, keeping exposure time short. However, we did not see any of these effects in our German PSD cohort. […] 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.

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

  https://www.freefrompiles.com/health-tips/pilonidal-sinus/

  Pilonidal Sinus is a condition characterized by the formation of a small tunnel or tract beneath the skin, commonly found in the sacrococcygeal region, which is the area at the base of the spine, just above the buttocks. […] The exact cause of pilonidal sinus is not entirely understood, but it is believed to result from the penetration of loose hair into the skin, causing an inflammatory reaction. Other contributing factors may include friction or pressure on the affected area, sedentary lifestyle, excessive sweating, and poor hygiene. […] The exact cause of Pilonidal Sinus is not fully understood, but several factors are believed to contribute to its development. Here are few potential causes: […] One of the primary factors in the formation of a pilonidal sinus is the irritation of hair follicles. Hair, particularly in the sacrococcygeal region, can become ingrown or embedded, leading to inflammation and the formation of a sinus tract.

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

  https://www.freefrompiles.com/health-tips/pilonidal-sinus/

  Prolonged sitting or activities that involve repetitive friction or pressure on the lower back can contribute to the development of pilonidal sinus. It is more common in individuals who lead a sedentary lifestyle or spend extended periods sitting, such as long-distance drivers or office workers. […] People with a higher density of body hair, especially in the sacrococcygeal area, may have an increased risk of developing pilonidal sinus. The presence of more hair increases the likelihood of hair penetration into the skin and the subsequent inflammatory response. […] There may be a genetic component to pilonidal sinus, as it tends to run in families. Having a family history of the condition might increase an individual’s susceptibility to developing it. […] Maintaining good hygiene in the sacrococcygeal area is essential to prevent pilonidal sinus. Inadequate cleaning or keeping the area moist can lead to bacterial overgrowth and infection, contributing to the condition. […] Although not a direct cause, obesity is considered a risk factor for pilonidal sinus. Excess body weight can lead to increased pressure and friction on the lower back, exacerbating the condition in susceptible individuals.

• #62 Pilonidal Sinus – USZ

  https://www.usz.ch/en/disease/pilonidal-sinus/

  A pilonidal sinus is an inflammation in the subcutaneous fatty tissue caused by broken hairs that have penetrated the skin. […] Researchers now assume that pilonidal sinus is an acquired disease that only occurs in the course of life. […] The causes of pilonidal sinus are broken hairs that penetrate the skin at the gluteal fold. […] The fact that the horny scales of the hair serve as barbs is conducive to penetration into the subcutaneous fatty tissue. […] The pressure on the skin when sitting and movements ensure that the hair is pushed further and further into the skin and irritates it. […] The skin reacts to the hair as if it were a foreign body and triggers an inflammation. […] A cyst forms around the hair, which contains hair fragments, granulation tissue (formed during wound healing) and dead cell remnants.

• #63 Pilonidal Sinus – USZ

  https://www.usz.ch/en/disease/pilonidal-sinus/

  In many cases, however, the cyst becomes infected and a purulent abscess develops, which sometimes takes on larger dimensions (like a plum or tangerine). […] We know or discuss some risk factors that favor the occurrence of a pilonidal sinus. […] These include, for example: Age: The disease occurs more frequently in people between the ages of 20 and 30. […] Familial predisposition: Some studies have found a familial clustering of the disease. […] Heavy body hair: The likelihood of hair breaking off is increased. […] Overweight and obesity (adiposity), thick subcutaneous fatty tissue. […] Deep buttock crease, large buttocks. […] Skin disease acne inversa. […] Heavy sweat production, especially during puberty. […] Frequent sitting in everyday life and at work, for example at a desk, in the car or at home. […] Wear tight, air-impermeable clothing. […] Lack of personal hygiene, especially in the anal area.

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