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Simple Dimples
Many healthy babies have small dimples on their lower backs. A mother who had just graduated from nursing school came to my office hours chat this week at DrGreene.com. Her baby had one of these sacral dimples. Her pediatrician told her not to worry about it and ordered an ultrasound in two weeks. Of course she worried – especially after a quick online search of sacral dimples raised questions of spina bifida and neurologic problems. So, at her request, I’m making what we chatted about available for others who are concerned about sacral dimples -- the simple dimple plan for parents. The first thing that parents need to know is that sacral dimples and related findings are common: about 1 in 20 babies. And most babies with midline sacral dimples are healthy. Occasionally, these dimples can be a sign of a spinal problem underneath. Sometimes, they are not even true dimples at all, but narrow open tubes that connect to an internal structure such as the intestines or the spinal canal. How do you tell the difference between dimples to smile about, and those to look into further?
There are four simple things to consider:
Is the dimple
- deep (the bottom can’t be seen)
- large (>0.5 cm in diameter)
- high on the back (> 2.5 cm above the anus) or
- associated with other skin findings at the site of the dimple (a tuft of hair, a tail, or a Hemangioma)?
If the answer to any of these is yes, then a closer look, such as an ultrasound, may be in order to see what is underneath. Even so, in one study of babies who met at least one of these criteria, most of the dimples (60 percent) turned out to be normal findings in healthy kids. Most of the dimples that did turn out to be problematic were both high on the back and also associated with other skin findings.
Simple dimples that don’t meet any of the above criteria turned out to be normal findings in 100 percent of the babies studied. In otherwise healthy babies, no ultrasound or other workup is recommended for simple dimples.
Click here to hear the audio of this article.
Alan Greene MD FAAP
Reviewed by Alan Greene MD FAAP December 2005
July 26, 2005 | Permalink
Comments
I am 17 years old and believe that i have a sacral dimple, sometimes it will be painful for me to sit down but this hasn't happened for a very long time, I haven't been to the doctors about it and don't even know if my mum knows a bout it. I dont think I will go to the doctors about it, as i only really noticed it when i was about 15. If it starts to hurt again i think ill take a visit at the dr's, its so embarrassing tho!
Posted by: Amy | Jun 19, 2009 5:29:49 AM
i wasnt born with a sacral dimple i was born with a hole in my back, well not actually a hole i was born with a severely thin layer of skin on my back, so thin you could see everything inside now it has developed into a very embarrassing scar and there is extra space between my lower back and the beginning of my buttox, i believe its call a "Hickman's Dimple" or something, my aunt died at 6 days old from the same thing i am 25 and still alive!!! be thankful for your lives it was a fight for me i will pray for those of you who are strugling with similar cases with your children
Posted by: Kathryn | May 19, 2009 11:37:42 PM
I am 21 and i have only just been told by my mum that i have a dimple just above my anus in between the butt cheeks... i personally cannot see anything and haave always concidered to be normal...however... when my son was born it looks like he has the exact same thing!! it has never caused me any problems i never even new it existed, doctors said it was okay because there was no hair coming from it (my son's) it is very small and u can hairdley see its very low down right next the the anus also there is an end to it. i was never offered any further tests, scans etc...also there is hardley anything about adults with sacral dimples? i would like to know if it causes any problems as you get older??
Posted by: Nikki | Apr 28, 2009 1:18:21 PM
My daughter discovered she had a pilondial cyst last year when she was 15. We ended up at the Pediactic office. Who did not know what to make of it and sent us to a surgeon-who wanted to open it up and let it heal. We ended up at a colon-rectal Doc. who just cleaned out the long sinus tract which had some hair in it. The hair was irritating the cavity. The hole was not visable to me when she was a baby. The hole is about the size of a pencil eraser. There seems to be a thinning of the skin slightly above the hole. Maybe a second hole started. She did have a lot of pain sitting and doing sport activities that put pressure on that area. I think the area is more comfortable now that the imflamation is gone. She was advised to keep the area hair free and dry as much as possible. So far so good! The Doc said if she developed symtoms again to come back for help cleaning out the tract again. She is thin. She always thought she was just too boney. But alas...a inflamed body cavity! I am thankful we did not do surgery-she is fine now. That would have been too much for this managable condition.
Posted by: Kathy | Apr 22, 2009 6:50:45 AM
My daughter was born with "funny" toes and a sacral dimple- it went misdiagnosed for 9 months. We were told she had stiff tendons in her feet. Due to a job change and a move we had to find a new doctor who ordered a MRI on her first visit. She was diagnosed with a Tethered Spinal Cord and had the surgery to detether it a month later. My opinion is better to know then know the wrong info. Get a second opinion if it isn't sitting right with you. My little one is 2 weeks post surgery and doing terrific. Lucky for her we found a doctor who knew what to look for and didn't wait to order the correct test. It will save her alot of problems and medical treatments in the future.
Posted by: Lisa | Feb 20, 2009 2:54:32 PM
Husband has a sacral dimple, and my daughter was born with one, too. When I pointed it out to him, he just thought it was normal! The midwife assured me it was just normal, and there was no spinal involvement. I suppose it's just another genetic thing, like their big brown eyes!
Posted by: Nicola | Jan 19, 2009 1:23:56 PM
at 26 now i realize the only down side side of this defect is being embarresed with a sexual partner.... Like the other poster a few lines up i usually start with the worst case of birth defect and since i am a bit over weight i am wondering if that has a link to the depth. I can feel the end which isnt quite deep but losing weight im hoping will help me again with some embarresment. All research ive done comes up with only infants nothing for adults. If any one has camme across a site for adults please share.
Posted by: | Jan 19, 2009 5:08:42 AM
i am 35-year-old woman and have a sacral dimple. it has never ever been a problem, and is barely noticeable. i don't know what the big deal is for everyone - 1 in 20 people have one, and if they have good personal care routines, this should never be a problem. 1 in 20 is quite significant, if you really consider it.
Posted by: mm | Jan 17, 2009 10:22:05 PM
I noticed a small hole on my baby at 4 days old. No one at the hospital even noticed it. I took her to 1 week check up and Dr. said it looked fine and not to worry about it. I took her back at 2 1/2 weeks old for check up and showed it to her again. Then she noticed the hair patch she did not notice the 1st time. It was there she just didnt notice it. I'm going for ultrasound in a few days. I've gotten really worried since researching the problems that can be associated with the dimple and hair tuft. There were some conditions that they say ultrasound wont pick up or very hard to see. They say to do an MRI before 2 months of age is the best chance to pick up any problems. Also, that if we dont see any problems on ultrasound and do not do MRI that later on in life if notice incontinence, bowel problems, leg problems etc. that surgery would not be able to repair some or all of the problems. It would be to late. Any input into this.
Posted by: Kelley Richard | Jan 17, 2009 12:09:50 PM
o and also i do have lower back problems my tailbone is real sensitive does this have anything to do with that?
Posted by: dm | Dec 30, 2008 3:08:26 PM
i was born with two sacral dimples r whatever they are (fin imbarresing) right on top of each side of butt crack is there a way i can get rid of them? should i see a doctor about them? theres no hair or nothing there pretty deep what should i do?
Posted by: dm | Dec 30, 2008 3:03:55 PM
I either have a pilonidal cyst or sacral dimple. my mom is taking me to the doctor to get it checked out again. I only have a pretty large and deep hole right above my butt crack. the dr told me when i was only a few weeks old that the hole was closed and now i'm 15 and i've never had any pain. my ped is still worried about it so shes going to check it out and then think about surgery cuz those can still get infected.
Posted by: Leah | Dec 14, 2008 12:45:40 PM
I either have a pilonidal cyst or sacral dimple. my mom is taking me to the doctor to get it checked out again. I only have a pretty large and deep hole right above my butt crack. the dr told me when i was only a few weeks old that the hole was closed and now i'm 15 and i've never had any pain. my ped is still worried about it so shes going to check it out and then think about surgery cuz those can still get infected.
Posted by: Leah | Dec 14, 2008 12:45:36 PM
My son (born in 1973) has one. (They don't go away.) When I pointed it out to my husband, he said "yeah, you have one too." I wasn't aware of it until then. About 12 years ago I found out my mom had one too.
Posted by: Sheri | Nov 6, 2008 1:28:03 PM
I am 25. I have what i believe to be this...sacral dimple. man I got torchered growing up for it. Mine is NOT small, it is large enough to put your index finger in. I can not see where it ends, though I think it's closed. I have some issues with urination, well, I pee, when i sneeze.lol. embarrassing but true. My son was born cleft lip and palate, is there a conection? My whole life, and today, at 25 I think I know what that extra hole is.
Posted by: Elizabeth | Oct 21, 2008 9:28:14 PM
I am a 27 yr old female and I guess this is what I have. I have never had any problems or weird things happen to it, like puss, blood, hair, pain, etc... It is just like the rest of my body. It is located at the top part of my butt crack. It must be some what of a deep hole. I cant see the bottom(not that I can see in it anyways).I would say it is about the size of this o. I was born with it. My sister has a light indent, so I am guessing that is what she has too. My mom has told me before her brother has one too. My boyfriends son has one as well and it is a light indent also. So I guess you can say we are some what normal? I feel normal atleast. :)
Posted by: freddy26 | Oct 13, 2008 9:29:33 PM
Hi, My son, husband and mother-in-law all have the sacral dimple. My husband got a pilondial cyst a few years ago and his doctor wanted to do surgery. I bought these Chinese detox patches on ebay and made him put the patch in his crack while he slept and the cyst and pain were gone the next day! It hasn't come back in years and he never needed to see the doctor again. When my son gets older I will make sure he keeps his dimple hair free and buy some detox patches just in case.
Posted by: Becky | May 7, 2008 7:50:10 PM
I am 25, I have diagnosed myself with a Sacral Dimple, Thru many many pages of internet research I have found almost nothing about adults with the condition. Up untill a few years ago it was never an issue. I have no pain. The most you parents should worry about (unless the doc. says otherwise) is the emotional stress an adult may have from this, Since it it a physical "defect" or noticable indent in the buttocks it makes for uncomfortable sexual intamacy. I am embarresed about it. I usually "Nair" the small patch of hair that grows (its really not much at all). When I tell my boyfriend about it, I usually start out with the worst senario of Spinal Bifida. This usually make for a sympathy reaction rather than someone being "grossed out". I mean 'cause think about it, it looks like another hole. Not attrative. but I deal. I guess that is the long term effects of the condition.
Posted by: Mary | Apr 24, 2008 5:28:49 AM
MY DAUGHTER HAS TWO DIMPLES,ONE ON EACH SIDE OF HER CREASE AT THE TOP OF THE BUTTOCKS.SHE HAS HAD AN ULTRASOUND WHEN SHE WAS ABOUT 4 MONTHS OLD,BUT DOCTORS WERE NOT ABLE TO SEE ANYTHING.SHE HAS BEEN REFERRED TO HAVE A MRI,BUT I'M JUST NOT SURE ABOUT HER HAVING ONE. MY DAUGHTER IS NOW 19 MONTHS AND HER MOTOR SKILLS ARE WONDERFUL.I JUST WANT TO WHAT SHOULD I DO AND SHOULD I BE WORRIED ABOUT ANYTHING.
Posted by: JAMIE ARMSTRONG | Mar 31, 2008 1:51:01 PM
im 21 and i believe that i have a sacral dimple. up until recently when my boyfriend asked what it was. i thought it was normal and that everyone had it. i have constant lower back pain. my sd is about 1cm wide and it is deep and and two inches from my anus. my mom teased me as a kid about having a crooked crack.i wonder if she knew i had one?!
Posted by: ec:( | Jan 6, 2008 9:43:24 PM
My son is three months old now and I discovered he had a sacral dimple upon taking him home from the hospital (they missed discovering it when he was in the NICU). We had an ultrasound done which showed that most likely there was no spinal involvement, but it did show a long sinus tract that they were unsure of where it led, and so they want to do an MRI when he's 6 months old. I really don't want to have him sedated for this -- what are the implications of refusing this -- or what is the worse case scenario? My dad says he also had a large deep sacral dimple as my son has --- can it be genetic? My son has no obvious neural deficits or impaired movement. Is it irresponsible to refuse the MRI unless there appears to be a medical reason for it?
Posted by: Alicia | Jan 1, 2008 12:32:51 AM
I had a friend who's baby had one and dr. insisted on an mri. The baby ended up being fine but after taking a nap when she got home she never woke up. :( I would think twice about this procedure.
Posted by: lori | Dec 20, 2007 4:47:07 PM
My daughter has sacral dimple as well as tuft of hair, 2days old had Ultrasound, cord is not tethered, Dr. has adviced MRI after 4 months
Posted by: manisha | Dec 10, 2007 9:18:54 PM
my daughter has a sacral dimple with a tuft of hair growing out of it. the first pediatrician i went to said dont worry about it. i was worried it didnt sseem normal to me cause i never heard of it before. i went to the best pediatrician in the area. he said not to worry the hair could be because she is italian...but ordered an u/s anyway.
the u/s showed a tract going from her spine to the dimple. the radiologist said that her cord is not tethered. we were told we needed to see a neurosurgeon. well they recommended the chief neurosurgeon at the best childrens hospital around. im of course scared out of my mind. my daughter is now 4 1/2 weeks old...i dont know what to think.
so yesterday 11/2/06 we went to the neurosurgeon and he wanted an mri. here her cord is tethered (borderline tethered) and he wants to wait on surgery for 3 months to re-evaluate her.
and right now im waiting to hear from the dr today on possible scoliosis of the spine and a cyst that was found as well!
but no tract from the spine to the skin...
how can these dr's vary in what they see?!
im scared to pieces and have done nothing but crying constantly.
i dont want her to have any neurological problems and im scared...
Posted by: Angeline | Nov 3, 2006 6:56:26 AM
My 4 month old daughter has got 2 sacral dimples or pits in the crease of her buttocks.
I was asked by the plunket nurse to get it checked by the GP, When i showed him, he began looking for more info on the net as well as ringing other doctors, I was advised not to worry, but how can you not. Is is something i should be worried about, will she have a minor case of spinal bifida what do i do?????
Posted by: Daniella | Sep 20, 2006 2:10:21 AM
