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A pilonidal sinus (PNS) is a small hole or tunnel in the skin. It may fill with fluid or pus, causing the formation of a cyst or abscess. It occurs in the cleft at the top of the buttocks. A pilonidal cyst usually contains hair, dirt, and debris. It can cause severe pain and can often become infected. If it becomes infected, it may ooze pus and blood and have a foul odor. A PNS is a condition that mostly affects men and is also common in young adults. It’s also more common in people who sit a lot, like cab drivers.
The exact cause of this condition isn’t known, but its cause is 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.
You may not have any noticeable symptoms at first other than a small, dimple-like depression on the surface of your skin. However, once the depression becomes infected, it will quickly develop into a cyst (a closed sac filled with fluid) or an abscess (a swollen and inflamed tissue where pus collects).
If your case is diagnosed early on, you aren’t experiencing severe pain, and there’s no sign of inflammation, it’s likely that your doctor will prescribe a broad-spectrum antibiotic. A broad-spectrum antibiotic is an antibiotic that treats a wide range of bacteria. It’s important to realize that this won’t heal the sinus tract, but it will give you relief from the infection and discomfort. Your doctor will recommend that you get a follow-up exam, regularly remove hair or shave the site, and pay particular attention to hygiene.
A condition called paraphimosis can also result when the foreskin is retracted, but can’t be moved back into its normal position. This may require emergency medical attention. One complication of paraphimosis is a reduction in blood flow to the end of the penis. The treatment options for paraphimosis are similar to those for phimosis. Lubricating the glans and the foreskin may help slide the foreskin back up. Before trying this at-home treatment, you should discuss it with a doctor. Have the doctor recommend brands and types of ointments or lotions that are safe. If the paraphimosis continues for several hours, color changes occur, or there is pain, you need to get a medical evaluation immediately. Circumcision or partial circumcision can eliminate the concerns of foreskin retraction. Be sure to discuss the risks and benefits of this procedure with a doctor. Being uncircumcised places a man at a higher risk of HIV and other infections.