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Pilonidal Sinus

What is a Pilonidal Sinus?

A Pilonidal sinus is a small tunnel or hole in the skin that gets filled with pus, fluid, and debris causing the formation of a cyst or abscess. A pilonidal sinus occurs in the cleft at the top of the buttocks. Along with fluid and debris, a pilonidal sinus is often filled with hair and dirt. The condition can lead to severe pain and the infection is likely to spread to the nearby body parts if not treated on time. When infected, a pilonidal sinus may ooze pus and infected blood and emit a foul smell.

Pilonidal Sinus formation

How does a pilonidal sinus form?

Pilonidal sinus is basically a skin problem. When there is too much friction and pressure in the anal area, the hair between the buttocks gets pushed inward. This may either be caused by the hairs growing around the buttocks or due to the loose hair shed from the buttocks area that gathers around the cleft and gets into the pilonidal sinus.

Types of disease

Acute pilonidal sinus

Acute pilonidal sinus

Chronic pilonidal sinus

Chronic pilonidal sinus


  • Changing hormones
  • Friction from the clothes
  • Hair growth in the buttocks
  • Sitting for long hours


  • Irritation in the skin
  • Small dimple
  • Large painful mass (inflammation or abscess)
  • Clear, cloudy, or bloody fluid drainage from the affected area
  • If infected, the area becomes red and tender and the drainage (pus) smells foul
  • Fever and nausea


If it is a case of a prominent and severe pilonidal sinus, the anorectal specialist will be able to diagnose it just through physical examination. In case the doctor cannot evaluate the condition just by looking at the pilonidal cyst, the following tests are recommended for diagnosis. Common tests which are done to pilonidal sinus piles are:

1. Digital examination – In this test, the proctologist inserts a gloved, lubricated finger into the rectum to check if there are any kind of abnormal growths. The test also confirms the depth of the tunnel and how far the condition has grown.

2. Visual inspection – In visual inspection, the pilonidal sinus specialist might examine the lower rectum using a proctoscope, an anoscope, or a sigmoidoscope. Using any of these devices, the doctor will carefully examine the lining of your anal tissues to check the severity and growth of the tissues.

3. Lab swab test – In rare conditions, the proctologist might recommend the patient undergoes a lab swab test. During the test, the doctor takes tissues from the affected area and sends them for a biopsy. The test is done to check if the tissues have grown cancerous to determine the best line of treatment where the pilonidal sinus grows severe.

Test of Pilonidal Sinus

Risks & Complications

Pilonidal sinus surgery is not complex but one needs to make sure that he or she in the right hands. Undergoing the surgery at the hands of a trained doctor cuts down the chances of your risks significantly. But, like any other surgical treatment, the success or risks associated with pilonidal sinus treatment are also highly dependent upon the severity of the condition and the surgeon’s experience. Although not very common, a patient may suffer from any of the following conditions during or after the surgical treatment of pilonidal sinus.

  • Trauma and bleeding – If the surgery is not efficiently performed, there is a chance that the anal tissues might be injured. Trauma and injury to the injuries may lead to bleeding. The chances of bleeding during pilonidal sinus surgery is higher in the case of open surgery. The risk of injury entirely depends on the experience of the surgeon who performs the surgery. Additionally, the complication may also get severe or lower depending upon the condition of the pilonidal sinus.
  • Infection – Infections can develop at any point during pilonidal sinus surgery. The chances of the surgical site getting infected are higher in case of open surgery or in cases where the patient does not allow the site to heal properly.
  • Reaction to anesthesia – Several patients report experiencing side effects of anesthesia. Due to the reaction, the patient might feel drowsy and nauseated for a longer time than usual. This is not a very complex risk. But if the effects of the anesthesia remain for longer than usual, the patient should consult with the doctor.
  • Squamous cell carcinoma – A form of skin cancer that occurs due to uncontrolled growth of the squamous cells. Although a very rare complication, people have reported suffering from the complication.
During Pilonidal Sinus surgery

When To Consult A Doctor For Pilonidal Sinus?

Knowing when to seek professional help for any health condition is extremely important for the right treatment of any anorectal disease including pilonidal sinus. Getting medical help at the right time can help you avoid unnecessary complications. Schedule an appointment with a reliable proctologist if the sinus tract becomes suddenly painful or swollen. This could be indicative of infection or rupture in the pilonidal sinus. 

If you experience any of the following complications or conditions, it is time you check with an anorectal surgeon.

  • You have excruciating pain and discomfort in your anal area or while making a bowel movement.
  • Foul and smelly stool appears when the infection spreads.
  • No amount of medications and home remedies are able to provide you relief from your symptoms.
  • If you feel dizzy and uncomfortable due to the constant discharge of pus and debris.

Questions to ask your doctor .

How serious is the condition of my pilonidal sinus?
Will home remedies and medicines provide me relief for my condition?
Is surgery necessary for my condition?
How long would be my downtime after the pilonidal surgery?
When will I be able to get back to my regular work life after surgery?
Will surgery provide me permanent relief from the pain and discomfort?
Are there any risks and complications of surgical treatment?
How can I prepare for the surgery?
How long will it take me to recover after the surgery?
Will your team help me throughout the treatment and after?
Will you provide assistance after the surgery in case my wound does not heal?
What is the success rate of pilonidal sinus treatment at your clinic?

Treatment options & cost

If there is no sign of inflammation or infection, the first line of treatment that the doctor is likely to suggest is a broad-spectrum antibiotic. A broad-spectrum antibiotic can treat a wide range of bacterial infections. The ointments do not heal the sinus tract but will provide symptomatic relief from the infection and pain. Your doctor is likely to recommend a follow-up test and maintain proper hygiene of the anal area.

Cities Where We Treat Pilonidal sinus


How do I know I have Pilonidal Sinus?

Some of the symptoms to look out for Pilonidal Sinus are:

  • Formation of a small dimple like structure
  • Large painful mass
  • Watery, purulent discharge from the pilonidal sinus
  • Pain while sitting or a little push due to tight clothing.
Can a pilonidal sinus heal on its own?

In some cases, a pilonidal sinus can heal on its own. But then it can recur and cause other infections also. Hence, it is recommended to undergo laser surgeries that provide permanent relief and it is completely painless.

Can pilonidal cyst or sinus be drained at home?

You should not drain the cyst or the sinus at your own risk because it may increase the risk of infection in the affected area. If you do not have the access to sterile materials, bacteria can enter the wound which can further cause infection. Hence it is better if you consult with an experienced proctologist and undergo the treatment from a pilonidal specialist only.

Does a pilonidal sinus keep recurring?

The most common reason for recurrence of a pilonidal sinus is incomplete drainage of the cyst or the sinus tract. If the drainage of the cyst remains incomplete, the pilonidal sinus can recur in the near future. Later recurrence of the pilonidal sinus happens mainly due to tension and trauma in the midline cleft. In some other cases, the sinus reappears due to any infection that builds up and accumulates in the cleft area because the wound does not heal properly.

Can pilonidal sinus be treated with antibiotics?

No, antibiotics can only provide relief from the symptoms and not the condition at large. Antibiotics do not provide a permanent cure to any anorectal disease including pilonidal sinus. If you experience swelling, redness, and itching in the anal area, using antibiotics can provide you relief from these symptoms. But if you are looking to drain the pilonidal sinus tract and get permanent relief, you should rely on surgical treatment.

Does pilonidal sinus surgery hurt?

Pilonidal sinus is a comparatively less painful surgery than any other form of anorectal surgery. But there may be instances where the person might feel some pain. In that case, the doctor is likely to prescribe pain medications and ointments for quick relief. Once you get relief from the pain, you can consult with your anorectal surgeon and stop taking the medicines.

How to avoid complications after pilonidal sinus laser surgery?

If you go through with the laser procedure for pilonidal sinus treatment, the chances of encountering any problems or complications are negligible. Just make sure you take proper rest and follow all the postoperative instructions provided by your doctor and your recovery will be completely smooth.

What is the difference between a pilonidal cyst and a pilonidal sinus?

A pilonidal cyst is a cyst filled with fluid or pus that forms near the natal cleft. On the other hand, a pilonidal sinus is a tunnel/channel that forms inside the natal cleft due to recurrent anaerobic infections in the region.

Is pilonidal sinus hereditary?

The risk of developing pilonidal sinus can depend upon factors like the shape of the buttocks and the extent of hair growth. Since these factors are genetic and get travel from one generation to another, it can be said that certain factors causing pilonidal sinus are hereditary.

Can pilonidal sinus cause cancer?

In rare and severe cases, pilonidal sinus can increase the risk of a certain type of skin cancer called squamous skin carcinoma. Therefore, it is advisable to seek medical attention for the pilonidal sinus in time.

Facts and statistics around Pilonidal sinus:

Why Choose Pristyn Care for Pilonidal Sinus Surgery?

  • Pristyn Care is a certified Centre of Excellence for anorectal treatments for diseases like pilonidal sinus, fissure, piles, and anal fistula.
  • Pristyn Care houses some of the top anorectal surgeons of the country who have years of experience in delivering surgical treatment anal fissure – acute and chronic with a high success rate.
  • Pristyn Care is associated with some of the top hospitals across India that are equipped with state-of-the-art facilities required to perform advanced anorectal surgeries.
  • Proctologists/ General Surgeons working with Pristyn Care do a thorough consultation in the case of every patient to understand the health condition and then determine the treatment method that will work best.
  • To ease out the commuting process for our patients, we also provide free cab facilities to bring you from home to the hospital and help you return back home after the surgery.
  • A free-of-cost follow-up is provided to the patients within the first seven days after the surgery.
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