Pilonidal Disease or better known as Pilonidal Cyst is a chronic inflammatory process that affects the intergluteal region between the buttocks.

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In the vast majority of cases, the lesion develops at the very beginning of the groove a few centimeters above the anus. The causes of the pilonidal cyst have not yet been fully defined and the cure is always one of the biggest debates as we see today, but going back to 1833, Herbet Mayo was responsible for the initial description, years later Anderson published "Hair extracted from an ulcer" in 1847.

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At first, it was thought to be a congenital problem caused by folds of embryonic tissue that remained in the subcutaneous region (at least that was what happened in other types of dermoid cysts).

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Currently, the most accepted theory is that the injury is caused by loose hair that, through friction, pressure or heat, passes through the skin and becomes lodged in the subcutaneous layer. The presence of this foreign body generates an inflammatory reaction that promotes the formation of the abscess ( sinus).

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Another possibility is that hormonal changes associated with certain adverse conditions favor the manifestation of folliculitis. In addition to the factors that we will see in the next topics, there is the bacteria Staphylococcus aureus, a germ that normally lives on our skin and can cause infection.

 

There still remains the hypothesis that the origin of the inflammation is in what we call ingrown hairs, hairs that curve and penetrate the hair follicle again where they continue to grow, because they are unable to penetrate the superficial layers of the skin. And thus the term "Pilonidal" (nest of hair) is defined.