Facts about hair and pilonidal disease

Facts about hair and pilonidal disease

Some of the first research on the subject

The term “pilonidal” means “nest of hair”. We know that pilonidal cysts contain loose hairs. These hairs are not “ingrown”, but instead they are hairs that fell into the gluteal crease and found their way under the skin, either by entering a midline pore or directly piercing the skin itself. Until recently there has not been much research done on what kind of hairs are in the cysts, and why one patient develops pilonidal disease and another does not. Here are some of the more recent facts found by researchers in Germany:

• Stiffer hairs have more of a tendency to get in these cysts than softer hair.
• Most of the hairs in a pilonidal cyst come from the back of the head.
• Hair on the back of the head is stiffer than the hair in the gluteal crease, possibly explaining why hair from the head is more common in cysts.
• Patients who sweat more have LESS incidence of pilonidal disease than the opposite counterparts. Wet hairs are less stiff, and this may explain why.
• Most of the hairs in a cyst are found to be short and have sharp ends and no roots.
• In spite of the usual precautions a barber takes to keep hair from from falling down a customer’s back, cut hairs are immediately found at the level of the low back after a haircut.
• I have not seen any evidence that showering is a critical time, and that it matters if you rinse your hair forward or back.

This information is all very new, and it’s significance remains to be seen. But, it does suggest that the time after a haircut may be critical in the penetration of pilonidal pits by sharp, stiff hairs, and an immediate shower is a good idea. Although we do not generally recommend hair removal as a solution to pilonidal disease, nor a necessity after cleft lift surgery, if you feel that you do want to do this, we don’t recommend shaving – but rather recommend using a clipper to keep the hairs short.