Pilonidal Sinus In Adolescents And Young Adults: Special Considerations

Pilonidal sinus is a common condition that affects the skin and subcutaneous tissue in the sacrococcygeal region, typically at the top of the buttock crease. It is characterized by the formation of a sinus, or small tunnel, often filled with hair and debris, that can become infected and cause pain and discomfort. Pilonidal sinus most commonly affects adolescents and young adults, particularly males. This article will discuss special considerations for managing pilonidal sinus in this age group, including causes, symptoms, diagnosis, treatment options, and prevention strategies.


Pilonidal sinus is thought to be caused by hair follicles becoming embedded in the skin, leading to an inflammatory response. This can occur due to:

Friction and pressure: Activities such as sitting for long periods, cycling, or wearing tight clothing can cause friction and pressure on the sacrococcygeal region, contributing to the development of the pilonidal sinus.
Poor hygiene: Inadequate cleaning of the affected area can lead to the accumulation of hair and debris, increasing the risk of infection.
Hair growth: Adolescents and young adults often experience increased hair growth, particularly in the lower back and buttock area, which can contribute to the development of pilonidal sinus.
Genetic predisposition: Some individuals may be more susceptible to pilonidal sinus due to genetic factors.


Common symptoms of pilonidal sinus in adolescents and young adults include:

Pain and discomfort: The affected area may become tender, painful, and swollen, particularly when sitting or engaging in activities that place pressure on the area.
Redness and inflammation: The skin around the sinus may appear red and inflamed.
Drainage: The sinus may produce pus or blood, which can stain clothing and cause an unpleasant odor.
Fever: In cases of infection, individuals may experience fever and general malaise.


Diagnosis of pilonidal sinus is typically made through a physical examination of the affected area. In some cases, imaging studies such as ultrasound or magnetic resonance imaging (MRI) may be used to assess the extent of the sinus and identify any complications.

Treatment Options

Treatment options for pilonidal sinus in adolescents and young adults vary depending on the severity of the condition and whether the sinus is infected. Common treatment approaches include:

Conservative management: For mild cases, conservative measures such as keeping the area clean and dry, avoiding friction and pressure, and using warm compresses may be sufficient to relieve symptoms.
Incision and drainage: For infected pilonidal sinus, a simple procedure to drain the sinus and remove any debris may be necessary.
Surgical intervention: For recurrent or severe cases, surgical excision of the sinus may be required. There are various surgical techniques available, including excision with primary closure, excision with open healing, and less invasive approaches such as laser or radiofrequency ablation.

Special Considerations for Adolescents and Young Adults

There are several factors to consider when managing pilonidal sinus in adolescents and young adults:

Impact on lifestyle: This age group is often active and engaged in sports, work, or other activities that may be affected by the condition. Treatment plans should take into account the individual’s lifestyle and goals.
Psychological impact: Adolescents and young adults may experience embarrassment or self-consciousness due to the location of the condition and its symptoms. Providing emotional support and counseling may be beneficial.
Education on self-care: Teaching adolescents and young adults proper hygiene and self-care practices can help prevent recurrence and improve outcomes.
Preventing recurrence: Emphasizing the importance of regular hair removal in the affected area and avoiding activities that cause excessive friction can help reduce the risk of recurrence.

Prevention Strategies

Preventing pilonidal sinus is key to avoiding recurrence and managing the condition effectively. Prevention strategies include:

Good hygiene: Keeping the affected area clean and dry is essential to preventing infection.
Hair removal: Regularly removing hair from the sacrococcygeal region can reduce the risk of hair becoming embedded in the skin.
Avoiding friction and pressure: Minimizing activities that cause friction or pressure on the area, such as prolonged sitting, can help prevent pilonidal sinus.
Weight management: Maintaining a healthy weight can reduce the risk of developing pilonidal sinus.


Pilonidal sinus is a common condition that affects adolescents and young adults, often causing pain and discomfort in the sacrococcygeal region. Proper diagnosis and timely treatment are essential to manage the condition effectively and prevent complications. By considering the special needs and concerns of this age group, healthcare providers can offer targeted support and education to help adolescents and young adults with pilonidal sinus maintain a high quality of life.