Pilonidal Sinus

Pilonidal Sinus

A pilonidal sinus is a small cyst that occurs in the cleft, the top part of the buttocks. Usually, a pilonidal sinus consists of hair, debris and dirt. It can catch infections and cause severe pain. With infection, it can ooze pus, blood and have foul odor.

This affects men in most conditions and is quite common in young adults, who sit for long hours and have no physical activities in their daily routine.


When the process begins, there might not be any noticeable symptom but for a small dimple near the top part of the buttocks. If it gets infected, the depression might turn into a cyst or an abscess. A cyst is a closed sac filled with fluid, whereas an abscess is a swollen and inflamed tissue where pus gets collected. If you have an infection, the symptoms are:

Low grade fever

Swelling of cyst

Pain while sitting or standing

Reddened and sore skin around the depression

Pus or blood oozing out from the depression

Foul odor in the sac

Hair protruding from the area

Holes in the skin

More sinus tracts over a period of time


Activities like sitting cause friction and prompt the growing hair in the buttocks, into going back into the skin. When hair retracts back to the skin, the body considers hair as foreign particles and launches an immune response against the hair. Because of this immunization process, a cyst gets formed around the hair. Although the root cause for pilonidal sinus has not been established for certain, the factors that contribute to it are:

Changing of hormones after puberty

Growth of hair

Friction from clothes

Spending a lot of time sitting


Conservative treatment

If your case is diagnosed early on, you aren’t experiencing severe pain, and there’s no sign of inflammation, it’s likely that your doctor will prescribe a broad-spectrum antibiotic. A broad-spectrum antibiotic is an antibiotic that treats a wide range of bacteria. It’s important to realize that this won’t heal the sinus tract, but it will give you relief from the infection and discomfort. Your doctor will recommend that you get a follow-up exam, regularly remove hair or shave the site, and pay particular attention to hygiene.

Laser Pilonidotomy 

If you have a recurring PNS or if you have more than one sinus tract, your doctor will recommend a surgical procedure.

You will first be given a local anesthetic. Then, the surgeon will open the lesions, removing all of the pus and debris. Once this process is complete, the surgeon will ablate the wounds and sinus with laser radiations and thus wound becomes sterile and the infection is taken care of which helps in early healing of the wounds.

After surgery, your doctor will explain how to change the dressings and will recommend shaving the site to prevent hair from growing into the wound.