Ayurvedic Treatment for Pilonidal Cyst

Pilonidal cyst is a cyst that develops at the bottom of the back, near the coccyx or tailbone. It can cause severe pain when infected and filled with pus. Once it is infected, it is called “pilonidal abscess,”. It looks like a big pimple or pustule at the bottom of the tailbone. It is more commonly seen in men than in women and more often in younger people. During World War II, a large number of soldiers got this disease that needed hospitalisation. It is thought to be developed from the irritation from riding sitting in the bumpy jeeps for long. So, in those times, the condition was called “Jeep disease.”

 Those who sit for a long time, like truck drivers, are more prone to this disease.  They can be treated successfully in most cases. If it is inflamed & painful, it can be drained or taken out surgically.

Signs & symptoms

Pain, redness, tenderness and swelling at the bottom of the spine

Pus or blood draining out of it with bad smell

Fever

Causes

The cause of pilonidal cyst is not exactly known. But most of them are caused by loose hairs that penetrate the skin. Friction and pressure, caused by skin rubbing against skin, tight clothing, bicycling, long periods of sitting or similar factors force the hair go or grow down into the skin.

Pilonidal means “nest of hair,” and hair follicles are found inside the cyst while removing it surgically. Experts say ingrown hairs are the most common cause of pilonidal cyst.

Another theory suggests that pilonidal cysts appear after a trauma to that are in the body.

A small dimple in the skin between buttocks at birth can be a risk factor for developing pilonidal cyst later in life.

Other risk factors include obesity, long & thick hair, sedentary lifestyle, prolonged sitting, and excessive sweating.

Pathophysiology

 

Hypothesises say that hair penetrates into the subcutaneous tissues through dilated hair follicles. It happens particularly in late adolescence, though follicles are not found in the walls of cysts. Upon sitting or bending, hair follicles can break and open a pit. Debris is collected in that pit, then a sinus develops with a short tract, with a suction-like mechanism, leading to further penetration of the hair into the subcutaneous tissue.This sinus tends to extend again, mostly due to mechanical forces involved in sitting or bending. A foreign body reaction can happen to formation of an abscess. Infection may end up in abscess formation.

Microscopically, the sinus where the hair enters is lined with stratified squamous epithelium with slight cornification. Additional sinuses are frequent. Cyst cavities are lined with chronic granulation tissue and may contain hair, epithelial debris, and young granulation tissue. Cutaneous appendages are not seen in the wall of cysts, meaning the cysts lack epithelial lining, unlike the sinus. Cellular infiltration consists of lymphocytes, and plasma cells in varying proportions. Foreign body giant cells in association with dead hairs are a frequent finding.

Diagnosis

In most of the cases, physical examination with detailed history can confirm the diagnosis

In rare cases, imaging techniques like USG, MRI etc. will be required.

Treatments

Antibiotics do not heal a pilonidal cyst. But there are therapeutic procedures including:

Incision and drainage: It is done mostly in a first pilonidal cyst. Making a cut into the cyst and draining it. Then any hair follicles are removed and leaves the wound open, packing the space with gauze.

Marsupialization: In this procedure, A cut is made and pus is drained. After removing pus and any hair that are inside, the doctor will sew the edges of the cut to the wound edges to make a pouch.

Incision, drainage and closing of wound: The cyst is drained, but it’s not left open. The wound is closed surgically.

It is important to obey all instructions by doctor, after a surgery.

Try to keep the area clean. Check for any signs of a new infection, such as redness, pus, or pain.

Continue regular follow ups to ensure the healing of the cyst.

Prognosis

A complete cure is possible in most of surgically removed pilonidal cysts, but chance of recurrence is high.

Complications

Abscess formation.

Recurrence of the pilonidal cyst.

Systemic infection (infection that spreads throughout the body)

Rarely, squamous cell carcinoma, a form of skin cancer

Disease & Ayurveda

            Naadeevrana(sallyaja)

Nidana

        Asaadhuvrtha  – inadequate drainage of sopha(swelling) or pooya(pus)

Purvaaroopa

        Not mentioned

Samprapti

        When the foreign body causes inflammation & swelling a cyst like sopha forms. In cases where this sopha is not incised& drained properly, the inflammation spreads into deeper tissues in the form of a tunnel and develops the naadeevrana.

Lakshana

One open wound on the skin outside the body

Pain & swelling, pain will be continuous & severe

Reddish,blackish discolouration may be present

Continuous and sero-sanguineous pus discharge from the open side

Fever and other systemic signs of inflammation will be present in acute infections.

Divisions

Vatika

Paittika

Kaphaja

Thridoshaja

Sallyaja/aaganthu (due to the presence of a foreign body)

Prognosis

            Kricchrasadhya

Chikithsa

            When nadeevrana is formed due to a foreign body, it should be extracted surgically. Once the foreign body is completely removed and the pus is drained out completely, the treatment for wound healing should be done. Symptomatic management for pain relief should be done along with main treatment.

Samana

Upanaaha – bandage to prepare the area for extraction of sallya inside

Poorana – filling up the naadee with herbs

Bandhana – bandage of the clear wound after the surgery

Kshaalana – washing the area with wound healing medicines

Sodhana

Paatanam/Chedanam/Vidaaranam – surgical removal of foreign body

Sallyanirharanam – extraction of sallya

Margapravisodhanam – drainage pus and residual tissue

Then treatment of wound should be done

Commonly used medicines

        Varanadi kashayam

Panchathiktakam Kashayam

            Chiruvilwadi kashayam

Dusparsakadi Kashayam

            Guggulupanchapalachoornam

            Kanchanaraguggulu

            Nalpamaradi kashayam

            Brands available

AVS Kottakal

AVP Coimbatore

SNA oushadhasala

Vaidyaratnam oushadhasala

Home remedies

Sit bath or soak the area in a tub of warm water

Keep the cyst and area around it clean and dry

Diet

  • To be avoided

Heavy meals and difficult to digest foods – cause indigestion.

Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine

Carbonated drinks – makes the stomach more acidic and disturbed digestion

Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)

Milk and milk products – increase kapha, cause obstruction in channels and obesity

Curd – causes vidaaha and thereby many other diseases

  • To be added

Light meals and easily digestible foods

Green gram, soups, honey

Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc

Behaviour:

Protect yourself from hot climate.

Better to avoid exposure to excessive sunlight wind rain or dust.

Maintain a regular food and sleep schedule.

Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.

Avoid sedentary lifestyle. Be active.

Avoid continuous sitting and squatting.

Avoid constipation.

Yoga

Exercises are completely restricted in cases of a severe infection. In mild cases or after surgery & follow up, regular stretching and mild cardio exercises are advised. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.

Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.

 Yoga can maintain harmony within the body and with the surrounding system.

Pavanamuktasana

Nadisudhi pranayama

Bhujangasana

Simple exercises for lungs and heart health

All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.

Research articles

https://pubmed.ncbi.nlm.nih.gov/10950015/

*These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake. Ayurveda Supplement with GMP Certification from India.

Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.

Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.

Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.

Dr. Nair is a regular speaker at Ayurveda-related conferences and has visited Germany to propagate Ayurveda. You can write directly to him-
rajesh@ayurvedaforall.com

Whatsapp – +91 9446918019, +91 8075810816

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