Ingrown hair problem in children who sit too long during the pandemic era!
April 2021
Unfortunately, the pandemic process is still not over. Our children are still at home, motionless. They are constantly sitting at the computer. When they sit constantly, they encounter the problem of pilonidal sinus or ingrown hair in street language. I tried to describe the pilonidal sinus in the pediatric surgeon’s journal.
A ball of hair and skin debris accumulating under the skin in the coccyx area causes malodor, discharge, infection and pain. Anyway, the Latin name pilonidal sinus comes from here; namely hair nest. It is not known exactly by which mechanism the hairs accumulate under the skin in the coccyx. However, in studies conducted; the presence of dyed hair in the hairballs removed after the surgery, increased frequency in people who are exposed to hair, such as dog keepers and barbers, and the localisation being mostly on the coccyx, that is, the blind area of the body in the middle of both hips, makes us think a mechanical reason. Also, the microscopic structure of the hair is like flounder, when we used to move it with our hands as a child, it always went forward. It ,s seen more on those with hard hair structure. As a result, the main risk factors are a sedentary lifestyle (like our children during the pandemic process), obesity, frequent trauma and irritation, having a strong and non-bending hair structure, a hairy and sweaty body. My last words remind you of adolescents, right?
The saying that pilonidal sinus disease is an adult disease is wrong. Strong hair, sweaty hairy body … Although it is most common in the second and third decades, its incidence generally decreases after the age of 30s. Among th adolescents whom we are interested in as pediatric surgeons, the average incidence at the age of 15 is 1.2 per thousand. Not less.
In order to be protected from acute or chronic infections, it is necessary to completely remove this hairball, hair socket, that is, the pilonidal sinus. If there are too many surgical techniques for an ailment, if the gold standard has not been established, understand that surgeons are still not completely happy with the results. As a matter of fact, this is the case with the pilonidal sinus. I will not tell you all the surgical techniques. But in recent years, the surgical approach has been shifting to smaller interventions. In April 2020, in the Journal of Pediatric Surgery, it was found that there were fewer complications, although there was no significant difference in the rate of recurrence in the comparison of sinus removal with trephine with extensive surgery. In March 2021, Surgical Endoscopy journal emphasized the ease and low cost of endoscopic cleaning and washing the pilonidal sinus, although it does not make any difference in the rate of recurrence. This month, in April 2021, Pediatric Surgery International reported a 90% success rate by giving 2-4 sessions of crystallized phenol into the nursery in children. Again, I wrote the links of these articles below.
What do we prefer?
Phenol is a substance that can have very harmful effects. It is banned in some countries such as Germany. It can cause burns on the skin, it cannot be performed without general anesthesia in children and it does not end in a single session. But there are good results in general surgery publications. If we have a little more knowledge, this technique can be used. Endoscopic cleaning and trephine removal techniques are very easy and the results we have achieved so far have been satisfactory. Of course, a proper hair cleaning should be accompanied by epilation. Your doctor will explain the details to you. But a new technique may emerge at any time because the recurrence rates are almost the same in all of them. Minimal interventions started to be more feasible.
Best of all, offer your children an active life, so they don’t sit around all the time.
It’s another end of a cruise.
And stay happy.
Prof. Dr. Egemen Eroğlu
The papers I have mentioned above:
Pediatr Surg Int2021 Apr 15. doi: 10.1007/s00383-020-04798-7.
J Pediatr Surg. 2020 Apr;55(4):747-751 doi:10.1016/j.jpedsurg.2019.06.014.
Surg Endosc. 2021 Mar 15. doi: 10.1007/s00464-021-08422-0.
