Pilonidal Sinus (hair bag)

The Pilonidal Sinus is most famous with the names “hair bag” and the “coccyx fistula” and others. As for the coccyx fistula in English and medically, it is Pilonidal sinus, as it is called the Pilonidal Sinus.

A hair bag, or as it is called, a Pilonidal Sinus is formed when a hole is formed in the lower back and the presence of falling hair, where the hair and skin cells collect to form a small cyst-like mass under the skin.

Pilonidal Sinus (hair sac) causes inflammation, pain, secretions, and swelling. It affects men more than females and most often affects people of young ages.

Causes of pilonidal sinus (hair sac)

There are a number of theories about the causes of the pilonidal sinus (hair bag), following which is a mention of the theory with an explanation of it, then a mention of the direct causes of the formation of the hair bag

Embryonic theory

The embryonic theory is based on the idea of migratory cells in the coccyx that cause pilonidal sinuses when they grow and get bigger.

other reasons

There are also other reasons, including:

Frequent long sitting

Sitting for a long period of time may be the cause of the hair cyst due to skin abrasion from repeated pressure on it.

No strenuous exercise

Exercising and activities that reduce the risk of infection increase the chances of developing a pilonidal sinus.

Injury in the coccyx region

Receiving cuts or bruises at the coccyx area increase the risk of developing a Pilonidal Sinus (hair sac)

Dead skin cells

Dead cells + falling hair + bacteria lead to the formation of the pilonidal cyst (hair sac).

Hair density

A person with thick back hair has a higher risk of infection 

Hereditary causes

The presence of this condition in the family history increases the possibility of developing it

Symptoms of pilonidal (hair bag) fistula

Symptoms of a coccyx fistula (hair bag) are as follows:

  • Lower back;
    pain, this pain may prevent the patient from sitting completely, with the opacity of a blood collection that is very painful, especially when sitting.
  • Tumor and;
    inflammation of the pilonidal zone (hair sac) can be seen by eye or touch. And swelling in the spine at its lower part.
  • Redness;
    as the pilonidal sinus (hair sac) tends to be red
  • Pus (pus);
    Pus and / or pus blood and blood is a symptom of an advanced stage hair cyst

Advanced symptoms in a pilonidal sinus (hair sac)

Blood + pus + severe pain + bad smell + yellow or white discharge

Coccyx fistula (hair cyst) prevention

Coccyx fistula (hair sac) can be avoided by following the following:

  • Take a shower daily, as personal hygiene is one of the most important prevention methods.
  • Hair removal from the roots Hair loss and its
  • collection are among the causes of the Pilonidal Sinus (hair bag). Therefore, hair removal from the roots is an important method for this, noting that removing hairs from the surface is not useful for prevention.
  • Avoid sitting on firm seats for long periods, and generally avoid long sitting.

Pilonidal Sinus (hair cyst) treatment

Conventional surgery

The traditional surgical method: where the entire area is surgically removed up to the coccyx bone, the entire tissue is scraped, and the wound is left open. This method requires bandages and a long period of healing and return to work.

Leather slide technology

The skin slide method: It is the same as the surgical method, but the wound is closed either directly with several stitches or a skin slice is manufactured, converted and placed over the wound and sutured, also this method is tiring for the patient as the wound is very wide and the pain after surgery is great and it takes a lot of time to return to work.

EPSIT laparoscopic fistula treatment

Pilonidal Sinus (hair bag) treatment with laser and endoscopy is the latest scientific method in the world currently for treating pilonidal sinus.

Advantages of EPSIT laparoscopic fistula (hair bag) treatment

  1. Without excision, incision, or cutting, because the treatment of the hair cyst is performed endoscopically
  2. without pain
  3. Without any complications
  4. Without bandages, no wound
  5. The patient returns to work and normal life the next day.

Dr. Khaldoon Al-Gharib compares different pilonidal methods in the next video (English subtitle is included)

FAQs about Pilonidal Sinus (Hair Sac)


Why is the Pilonidal Sinus called this name? Although it is a hair bag?

It is called as a result of its presence in the Pilonidal Sinus region.

I noticed that there was a small hole in my lower back as if it was a hair! And when squeezed out a foul substance, should I leave it?

It is better not to leave it, because it is a hair bag and you should see a doctor immediately

I have a hair bag that I diagnosed during the Corona season and I did not go to the doctor to remove it because of Corona, what is your advice to me?

My advice is to clean the area continuously and see the doctor as soon as possible so that an abscess does not form and the situation does not become difficult and complicated .. When the hair cyst is without infections, treatment is much easier.

I removed a hair bag 3 times during my life, and I don’t know if the condition will recur, what should I do to avoid the condition completely?

Recurrence (recurrence) in the case of a hair cyst is contained in all the techniques and methods of treatment, but in order to avoid relapse, we need 3 things: - To perform the treatment in the manner that needs the least surgery - To remove all the hair from around the area and to maintain personal hygiene and not leave any hair in Zone - Not sitting too long also helps.

Pilonidal Sinus treated cases

Patients who previously lived suffering from hemorrhoidal diseases and received treatment at the hands of Dr. Khaldoun, we list to you what they suffered from the symptoms and the treatment that was provided may be of benefit.