Sacral Dimple – Causes, Complications, and Treatment

A sacral dimple in newborn infants is commonly observed during routine examinations. While many consider it as normal as a birthmark, there is a chance that it may indicate the presence of an underlying spinal abnormality. In most cases, a sacral dimple is harmless, but deeper or unusually located dimples may be linked to spinal cord issues. It is important for healthcare providers to evaluate the dimple to determine if further testing is needed. Understanding whether a sacral dimple in infants poses a risk of complications and how to treat it correctly ensures the baby’s long-term health and well-being. Early detection and proper medical guidance can help address any potential concerns effectively.

What Are Sacral Dimples in Babies?

At times, certain babies tend to have a minor regression or indentation of sorts in the region of the lower back, resembling a dimple. This is also termed as a pilonidal dimple. In most cases, it doesn’t indicate any problem but might be a result of structural defects in the spinal region as a rarity (1).

Different Types of Sacral Dimples

A sacral dimple is a small indentation in the skin at the base of a baby’s spine, which is usually harmless but may sometimes indicate an underlying spinal condition. Below are the two types of sacral dimples (2).

1. Simple Sacral Dimple: A simple sacral dimple is shallow, located near the crease of the buttocks, and has no other associated skin changes. These dimples are common and typically do not require any medical intervention unless signs of infection, such as redness or discharge, develop.
2. Deep or Atypical Sacral Dimple: A deep sacral dimple extends more than 5 mm and may be positioned higher up on the lower back. These dimples are more likely to be associated with spinal cord abnormalities, such as spina bifida occulta or tethered cord syndrome, and often require imaging tests like an ultrasound or MRI.

How Common Are Sacral Dimples in Infants?

While sacral dimple with a tuft of hair might indicate the presence of a complication, a majority of the risk-free sacral dimples are quite common in infants, especially in newborn babies (3). At times, these are congenital while others might appear later in life.

Symptoms of Sacral Dimples

A sacral dimple can be easily observed as a depression or a tiny pit in the lower side of the back, usually right above the buttocks. Some other signs that can indicate its presence are (4):

• Tenderness or sensitivity in the area combined with swelling
• Slight discolouration of the region
• Abnormal neonatal spine imaging results
• A dimple that is quite evident, being deeper than 5mm
• Skin tags or a lump of fat in the area
• The presence of a birthmark or even a tuft of hair near the dimple

What Causes Sacral Dimples in Infants?

Even today, there doesn’t seem to exist any kind of conclusive evidence or factual information regarding the presence of sacral dimples in babies. Doctors are only sure of the fact that, in majority of the cases, the sacral dimple was present since birth, making it a congenital condition (5). The reasons behind its formation in the foetus, even when posing no risk, are yet to be known.

Diagnosis of Sacral Dimples

Any presence of sacral dimples can be easily observed right from the time the baby is born. Some doctors may decide to conduct further diagnosis to rule out the presence of any abnormalities. This is usually done if the dimple is evidently large, or contains discolouration or presence of hair.

A sacral dimple ultrasound is usually the first step in the diagnosis. The ultrasound is non-invasive, making use of sound waves as a means to construct the physical dimensions of the inner body. This can help determine any abnormalities in the formation of the spine. If that doesn’t provide enough clarity, an MRI might be conducted as a follow-up.

Complications of Sacral Dimples

Most of the time, the presence of a sacral dimple does not indicate anything serious. However, there have been rare occurrences where a major abnormality in the baby has been indicated by a sacral dimple (6).

1. Presence of a Tethered Cord Syndrome in the Baby

Tethered cord syndrome is a condition in which a part of the spinal cord attaches to the outer tissue. This restricts the movement that is possible and also results in the manifestation of various conditions, such as incontinence of bowels, bladder problems, weakness of the legs, numbness in the lower regions, and so on.

2. Presence of Spinal Structural Problems Like Spina Bifida

While spina bifida is usually a major abnormality, a milder form of it is termed as spina bifida occulta. A sacral dimple could be the result of such a condition, where the spine doesn’t fully close around the spinal cord. Its symptoms cannot be determined without any diagnosis.

Sacral Dimples Treatment

Simple and risk-free sacral dimples do not require any treatment. If you have a newborn with sacral dimple and if the diagnosis reveals the presence of structural abnormalities, then a neurologist might have to take a look at it and decide how to proceed (7).

FAQs

1. What is the difference between sacral dimples and pilonidal cysts?

Many of us tend to consider a sacral dimple to be the presence of cancerous tissue. However, there is a major difference between them. A sacral dimple is congenital, while a pilonidal cyst develops later in life. Dimples are usually harmless, whereas a cyst can get infected and filled with pus, requiring it to be removed surgically.

2. Can a sacral dimple develop after birth, or is it always present at delivery?

While most sacral dimples are congenital (present at birth), rare cases of acquired dimples have been reported due to trauma or infections. However, any new dimple should be evaluated to rule out underlying issues.

3. Does a sacral dimple affect a child’s mobility or potty training later in life?

A simple dimple typically has no impact. However, if linked to spinal abnormalities (like tethered cord), it could cause nerve-related issues affecting movement or bladder/bowel control—making early assessment important.

Parents often ask, ‘Baby sacral dimple—when to worry?’—typically if it’s deep, large, or accompanied by other signs like skin changes or developmental concerns. The presence of a sacral dimple tethered cord can be quite disturbing for parents, but in most cases, sacral dimple does not pose any problems. Taking corrective action early in life can help prevent any complications later on.

References/Resources:

1. NHS – Sacral Dimple Neonatal Clinical Guideline

2. Government of Western Australia Child and Adolescent Health Service – Sacral Dimples or Pits

3. Children’s Hospital Colorado – Sacral Dimples

4. Cleveland Clinic – Sacral Dimple

5. Mayo Clinic – Sacral dimple

6. Massachusetts General Hospital – Sacral Dimple: What You Need to Know

7. ResearchGate – Management of Sacral Dimples Detected on Routine Newborn Examination: A Case Series and Review

Also Read:

Baby Acne
Neck Rash in Babies
Enlarged Heart in Infants
Birthmarks in Newborn Baby