Sacral Dimple

What is a Sacral Dimple?

A Sacral Dimple is located on the lower back, right above the crease of the buttocks. This is an indentation that is present at birth and is usually a noticeable indent. The majority of sacral dimples are considered medically harmless. Harmless sacral dimples do not require any type of medical treatment; they just make the lower back appear different.

A sacral dimple visible at birth that is accompanied by one of the following can be considered medically concerning.

  • A tuft of hair
  • Skin tags
  • Skin discoloration of certain types

The above conditions are usually a sign that there is an underlying problem. Usually, the underlying problem is an abnormality of the spin, or even an abnormality of the spinal cord. If any of these conditions are partnered with a sacral dimple, your pediatrician may recommend specific imaging tests to determine whether an abnormality is present. If one is discovered, your pediatrician will recommend the appropriate course of treatment, keeping in consideration what the underlying problem.

What are the Symptoms of a Sacral Dimple?

A sacral dimple does not require medical treatment unless one of the following are present, with an underlying problem:

  • A tuft of hair
  • Skin tags
  • Skin discoloration of certain types

Even with the presence of one of these conditions, the sacral dimple itself does not produce any symptoms. The underlying disorder is what causes symptoms.

The symptoms associated will range drastically, depending on the underlying condition.

Sacral Dimple Causes

A sacral dimple is a small pit/cleft in the skin located on the lower back above the buttocks. It is relatively common in newborns and in most cases there are no health risks. Sacral dimples are a congenital condition, meaning they are present at birth and are common. There is no evidence to show that sacral dimples impede an individual from having a normal, healthy life. It is not known to have any negative effects on movement or lifestyle.

While sacral dimples are small anomalies that occur while the baby is in the mother’s womb, they are seldom a sign of concern. In some cases, it may be accompanied by a tuft of hair, skin discoloration or skin tags. In these instances, a doctor may recommend an imaging test. If the dimple appears to be deep, it may become infected when the child is older. Infection can occur by a collection of dirt, fecal matter and sweat.

How is a Sacral Dimple Treated?

A sacral dimple with no underlying condition does not require any treatment. However, if one of the following are present, treatment may be necessary:

  • A tuft of hair
  • Skin tags
  • Skin discoloration of certain types

Keep in mind, the treatment provided is for the underlying condition, and not the sacral dimple itself. The treatment offered will vary depending on what the underlying condition is.

While it is rare for a sacral dimple to be associated with any serious underlying disease or disorder, it is possible that this dimple can be an indicator of an abnormality of the spine or spinal cord. Your child’s pediatrician will perform imaging scans to determine whether the dimple is a visual anomaly, or something serious. Some conditions that a sacral dimple can be a warning sign of are:

  • Spina bifida: a condition where the spine does not close completely around the spinal cord. In most cases, the spina bifida present would be spina bifida occulta. This type of spina bifida does not cause any symptoms and is not considered to be a health hazard as long as the spinal cord remains inside of the spinal canal.
  • Tethered cord syndrome: this is a condition that is very concerning for doctors on delivery. The condition is easily recognizable on imaging scans. It is characterized by outside tissue becoming attached to the spinal cord. This attachment limits the cord and its movements. If it is not treated, the symptoms can be extremely serious. The symptoms include:
  • Full or partial weakness of the legs
  • Full or partial numbness of the legs
  • Full or partial bladder incontinence
  • Full or partial bowel incontinence

Each of the conditions listed above can be treated to a certain extent, depending on the severity of the condition. At times, repairing the breach in the spinal column can pose more of a risk than allowing it to remain how it is, unless the spinal cord is exposed.

Sacral Dimple Prevention

In general, children will not need to see a doctor about a sacral dimple as there are no risk factors for developing one. There is no prevention or treatment for a sacral dimple, but if it becomes infected or irritated, keeping the area clean and applying a rash cream over the pit can help dissuade any infection/swelling. Very rarely your doctor may want your child to undergo certain imaging tests to determine if there is any serious underlying abnormalities associated with the sacral dimple.

Examples of complications that may occur are Spina Bifida Occulta (which happens when the spine doesn’t properly close around the spinal cord) and Tethered Cord Syndrome (tissue attached to the spinal cord limiting its movements). Again, these are rare cases with warning signs such as a nearby tuft of hair, skin tags or skin discoloration. Please consult your child’s doctor, as treatment depends on underlying causes.