What is ingrown hair (Pilonidal Sinus)?

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Ingrown hair is a skin condition that occurs mostly in men and in the coccyx region. It is formed as a result of the hairs and hairs shed from areas such as the back, neck, scalp, embedded in the skin through the pores or gaps and accumulating here to form a cystic structure. Inflammation may also occur in the area of ​​ingrown hair. Apart from the coccyx, it can rarely be seen in other body parts such as the belly button. In Turkey, more than 15 – in women in recent years, the disease seen in men between the age of 35 has become a common problem. It is 3 times more common in men than in women. Early diagnosis and treatment of ingrown hair, which can cause serious complications such as abscess, severe pain, malodorous discharge, is important. However, in our society, physicians are not generally consulted for rectal diseases until the last stage of the disease. Patients can hide the situation they live in, not even sharing it with a physician, from their family.

What is ingrown hair (Pilonidal Sinus)?

Ingrown hair, which is called “pilonidal sinus” in medical literature, is a disease that can be prevented by ensuring hygiene conditions and removing the hairs in the body at regular intervals. However, after the disease occurs, the only thing to do is to apply to clinics and hospitals and get support from a general surgery specialist. Because ingrown hair is not an inconvenience that can pass by itself after a certain period of time.

In which parts of the body does hair rotation (Pilonidal Sinus) occur?

The most intense place of hair rotation in our body is the groove between the two hips called intergluteal groove in the coccyx. Almost all cases are seen in the coccyx. Although rare, some of them are found in the belly button. Apart from these areas, it can also occur in the face, groin area, fingers and armpits.

What causes hair rotation (Pilonidal Sinus)?

Experts put forward two different theories regarding the formation of pilonidal sinus. The first of these is the accumulation of hairs and hairs from the body, especially if there is perspiration, under our skin through holes and pores in the skin. It has been observed that the hairs that enter the skin during the movement of the body can reach around 60-70. The area where the bristles accumulate is surrounded by a membrane, creating a cystic structure. The fluid that occurs as a reaction to the bristles causes a foul-smelling abscess flowing out of the sinus mouth. Another less accepted theory that explains ingrown hair is that stem cells, which are present in the region, start to produce hair after the age of 20s as a result of the activation of hormonal effects.

What are the symptoms of ingrown hair (Pilonidal Sinus)?

Hair rotation is an insidious disease; However, there are signals given to the body during the accumulation of hair and hair under the skin. Symptoms that do not bother the patient in the initial stage may become unbearable in the later stages. Some of the symptoms observed in almost all of the patients who apply to the health institution due to hair rotation are listed below;

  • In the initial phase of the hair rotation, the current problem occurs. Patients who meet this humidity in underwear as usual are generally unaware of the case at this stage.
  • When this discharge combines with microbes, it turns into inflammation and turns green.
  • The current is accompanied by a bad smell.
  • Sometimes bloody discharge can be seen.
  • Other symptoms seen in hair rotation are itching, redness, swelling and pain in the anus.
  • Over time, the pain becomes so severe that the patient is no longer able to carry out daily activities.

The reason for the bad odor seen in the hair rotation is the inflammation of the related area and the abscess. Currents from the sinus mouth combine with microbes and prepare the ground for the formation of a malodorous and inflamed abscess. The size of the swelling that occurs in the pilonidal sinus area varies according to the density of the hairs accumulated in the area. The pain caused by the stretching of the cyst into an abscess may have an unbearable intensity. The person may become unable to sit and walk due to this pain. The presence of a pain in which even daily activities cannot be done is a sign that you are in the last stage of the disease. When one or more of these symptoms are encountered, you should avoid time-consuming methods such as herbal formulas and leave the job to the experts.

What are the risk factors for ingrown hair (Pilonidal Sinus)?

It is known by everybody that still life invites many diseases. In particular, one of the health problems faced by people working in desk jobs is ingrown hair. According to researches, it is reported that sitting upright reduces the frequency of ingrown hair. For this reason, prefer to sit in an upright position while working at a desk job or in everyday life.
It is worthwhile. As mentioned above, there is an increase in the frequency of ingrown hair in permanent sitting jobs such as riding. During the Second World War, hair loss occurred in the majority of the soldiers who had to use jeeps constantly. After a certain time, these cases were called “jeep disease”. Other risk factors for pilonidal sinus formation

  • Obesity
  • Poor personal hygiene
  • Excessive sweating
  • Extremely hairy body
  • Hair removal with a razor
  • Can be considered susceptibility to hair root inflammation.

At this point, the question of what is good for ingrown hair can be answered briefly by an active lifestyle, sitting in an upright position and cleaning the body hair at regular intervals.

How to treat ingrown hair (Pilonidal Sinus)?

In order to be able to treat ingrown hair, the abscess that develops in the area must be drained first. Inhalation treatment is applied 1-2 months after the abscess is completely drained and treated. Abscess evacuation is done in a short time period of 5 minutes in modern clinics and hospitals. The abscess is drained with a small incision that does not leave a scar on the skin and is closed by cleaning with a special liquid. This procedure performed by General Surgery Specialists must be performed in experienced hands.

Ingrown hair (Pilonidal Sinus) surgery

Ingrown hair surgery is performed in a sterile environment. Surgery is the most effective treatment option for ingrown hair. The possibility of recurrence of the disease is lower than the non-surgical method. The surgery is performed by making a small incision that will not leave any scar in the problematic area. After the operation, the incision area is cleaned well and then closed with stitches. Micro sinusectomy method, which is performed with local anesthesia and does not require anesthesia and hospitalization, is increasingly preferred since it has the least risk. It is preferred by patients and physicians since there is no scar on the patient’s body after the operation, he returns to his daily life by not staying in the hospital, and it is a short-term procedure such as 20-30 minutes and gives the same result as the classical surgical procedure.


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Op. Dr. Akın Kocaoluk


Op. Dr. Akin Kocaoluk | Resume


He graduated from 19 Mayıs University Faculty of Medicine in 1998. He is currently continuing his active career in Turkish Red Crescent Altıntepe Medical Center.




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