![]() ![]() 4 Factors such as the H-factor (hair), F-factor (forces such as depth and narrowness of the natal cleft), and V-factor (vulnerability) act together and cause first hair insertion, which is followed by the easy insertion of other hairs and, finally, development of PSD. Having treated thousands of PSD cases over 35 years of practice, Karydakis stated that various factors predispose patients to hair insertion, which results in PSD. The disease may be associated with sex hormones because it is most commonly observed between puberty and 40 years of age furthermore, it may be associated with a more hirsute nature because it is more frequently observed in males than in females. ![]() 1 It is common, particularly in young adults. The disease was first reported by Herbert Mayo in 1833 and first defined as “pilonidal sinus” by Richard Manning Hodges in 1880. The history of sacrococcygeal pilonidal sinus disease (PSD) began in the early 19th century. What is sacrococcygeal pilonidal sinus disease and what causes it? ![]()
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