This is an acquired condition and seen in adult males, this is hardly seen in females. While shifting the buttocks move and hairs broken off by friction and collect in the cleft. When the toilet paper is used hair entangled in foecal matter will also be swept into the cleft. Such loose hairs travel down the inter gluteal furrow to penetrate the soft and moistened skin at that region or enter the open mouth of a sudori ferous gland ,after the initial entry dermatitis and inflammation start around the loose hairs and once the sinus is formed intermittent negative pressure of the area may suck other loose hairs into the pit.
The hairs in the sinus are usually dead and are found lying loose in the sinus or embedded in the granulation tissue.
2.Surgical Excision of Track
Care should be taken even after surgery/ksharsutra to avoid accumulation of hairs and maintain proper hygiene. Permanent hair removal of natal cleft is good for cases of Pilonidal Sinus.