Sacral Dimples: Symptoms, Causes, and Treatments

Written by Medicover Team and Medically Reviewed by Dr Seepana Rajesh , Pediatrician

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A sacral dimple, also known as a pilonidal dimple, is a small indentation or pit in the skin on the lower back, typically located just above the buttocks. While usually harmless, it can occasionally indicate underlying spinal or neurological issues, warranting medical evaluation if associated with other symptoms such as swelling, drainage, or a deep pit.

What are the Symptoms of Sacral Dimples?

Most sacral dimples do not cause any symptoms. They are simply small indentations in the skin that are usually harmless. However, in some cases, sacral dimples can be associated with other symptoms or conditions, such as:

• Pain: Some individuals may experience pain or discomfort in the area of the sacral dimple.
• Swelling or Redness: If the dimple becomes infected, it may become swollen, red, or tender to the touch.
• Discharge: An infected sacral dimple may produce pus or other discharge.
• Hair Growth: In some cases, hair may grow from the sacral dimple.

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What are the Different Types of Sacral Dimples?

Sacral dimples are generally categorized based on their appearance, depth, and associated features. The two main types are:

Simple (Benign) Sacral Dimple

• Characteristics: Small (typically less than 5 mm in diameter), shallow, and located within 2.5 cm of the anus.
• Appearance: A single, midline dimple with no surrounding discoloration, hair, skin tags, or discharge.
• Associated Risks: Usually harmless and not linked to spinal or neurological issues.
• Management: Typically requires no treatment; monitoring by a pediatrician may be recommended.

Atypical (Complex) Sacral Dimple

• Characteristics: Larger than 5 mm, deeper, or located more than 2.5 cm from the anus.
• Appearance: May be accompanied by other skin abnormalities such as Hair tufts, Skin discoloration, Hemangiomas (red birthmarks), Skin tags, Drainage or fluid
• Associated Risks: Can be a marker of underlying spinal or neurological conditions, such as tethered cord syndrome, spina bifida occulta, or dermal sinus tracts.
• Management: Requires further evaluation with imaging (e.g., ultrasound or MRI) and possibly referral to a pediatric neurologist or neurosurgeon.

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What Are the Common Causes and Risk Factors of Sacral Dimple?

Sacral dimples are usually identified at birth and are often benign. However, understanding their causes and associated risk factors helps determine when further evaluation is necessary.

Causes (Origins)

• Congenital development: Most sacral dimples occur during fetal development when the skin over the lower spine doesn't fully close.
• Neural tube defects: In some cases, they may be associated with minor forms of spinal dysraphism, such as spina bifida occulta.
• Dermal sinus tracts: Rarely, the dimple can lead to an abnormal connection between the skin and the spinal canal.

Risk Factors

• Family history: Genetic predisposition to spinal abnormalities or dimples.
• Maternal folate deficiency: Low folic acid levels during pregnancy increase the risk of neural tube defects.
• Premature birth: May be associated with increased rates of developmental skin or spine anomalies.
• Presence of other skin markers: Such as hairy patches, skin tags, or discoloration around the dimple.

Understanding these factors can help guide early assessment and determine if further diagnostic imaging is needed.

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How is Sacral Dimple Diagnosed?

Sacral dimples are often detected during routine newborn exams, but some may require further evaluation to rule out underlying spinal issues.

• Physical examination to assess size, depth, and location.
• Ultrasound for infants under 6 months to detect spinal anomalies.
• MRI for detailed imaging if needed.
• Neurological evaluation if symptoms suggest nerve involvement.

Medicover offers advanced imaging, expert pediatric neurology and radiology departments, and a multidisciplinary approach, ensuring accurate diagnosis and early intervention using standardized newborn screening protocols.

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What are the Treatment Options for Sacral Dimple?

The treatment for a sacral dimple depends on whether it is causing symptoms or complications. In most cases, no treatment is necessary for a harmless sacral dimple. However, if the dimple becomes infected or is associated with other conditions, treatment may be required.

For Simple (Benign) Sacral Dimples

• No treatment needed: Most cases require only observation.
• Regular monitoring: Pediatric check-ups to ensure no changes or symptoms develop.

For Atypical or Complicated Sacral Dimples

• Imaging follow-up: MRI or ultrasound if signs suggest spinal involvement.
• Surgical intervention: May be necessary if associated with conditions like a tethered cord or a dermal sinus tract.
• Infection management: Antibiotics or minor surgery if there's discharge or abscess formation.

At Medicover, pediatric specialists tailor treatment based on diagnostic findings, ensuring safe, effective care with access to expert neurosurgeons and advanced surgical support if needed.

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When to See a Doctor?

While most sacral dimples are harmless, there are certain situations where you should seek medical advice. If you or your child experiences any of the following, it's important to consult a healthcare professional:

• Infection: If the sacral dimple becomes swollen, red, or produces discharge, it may be infected and require medical treatment.
• Pain: If there is continuous pain in the region of the sacral dimple, consult your healthcare provider.
• Associated Symptoms: If the sacral dimple is accompanied by other symptoms such as fever, changes in bowel or bladder function, or difficulty walking, it may indicate a more serious underlying condition.

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What Is the Recovery Process After Treatment for a Sacral Dimple?

Recovery depends on the type of treatment and underlying condition, but is generally straightforward.

• Follow-up schedule: Regular check-ups to monitor healing and detect any complications, typically starting a few weeks after treatment and continuing as needed.
• Lifestyle recommendations: Keep the area clean from infection, avoid tight clothing that can rub on the skin.
• Diet advice: No specific dietary restrictions, but a balanced diet supports overall healing and immune health.
• Long-term outlook: Simple sacral dimples usually have an excellent prognosis with no lasting issues; complex cases may require ongoing monitoring but often improve with timely treatment.

Medicover offers complete post-treatment care, ranging from specialist follow-up care to counselling and support, ensuring a full and stress-free recovery.

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What Precautions Can Help Prevent Sacral Dimples?

There is no known way to prevent sacral dimples since they are congenital. However, there are steps you can take to reduce the risk of complications:

• Keep the Area Clean: Regularly clean the area around the sacral dimple to reduce the risk of infection.
• Avoid Irritation: Avoid activities or clothing that may irritate the area around the sacral dimple.
• Monitor for Symptoms: Keep an eye on the sacral dimple for any signs of infection or other symptoms, and seek medical advice if needed.

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Our Experience Treating Sacral Dimples

At Medicover, we understand how concerns about sacral dimples can worry parents and patients alike. With years of experience and a compassionate approach, our dedicated team is committed to providing individual care that puts your child's safety and comfort first.

From thorough diagnosis to prepared treatment and follow-up, we walk with you every step of the way,offering expert guidance, advanced technology, and heartfelt support to ensure the best possible outcomes for your family. Your trust is our greatest priority.

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