Pilonidal Sinus

What is 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


The risk factors for pilonidal sinus are:

  • Male gender
  • Age in twenties
  • Inactive lifestyle
  • Prolonged sitting
  • Obesity
  • Excess body hair



The ways to prevent pilonidal sinus are:

  • Maintaining cleanliness and hygiene
  • Staying fit and active
  • Avoiding sitting for long hours at a stretch

How is it diagnosed?

No specific laboratory studies or tests are needed to diagnose pilonidal disease and its sequel or differentiate it from other disease entities. A clinical diagnosis best elicited by history and ph...

How is it treated?

At Medanta, the following treatments are used to cure the pilonidal sinus:


  • Conservative treatment

    A broad spectrum antibiotic that treats a wide range of bacteria may be used to treat pilonidal sinus, if diagnosed early. It is useful if there is only mild pain and no inflammation or reddening. Although the sinus tract does not get healed with this, it is required to provide relief from infection and for you to feel comfortable when you sit. It is necessary to keep the infected zone free from hair and dust, maintain hygiene and have regular follow up examinations.

  • Lancing

    When you are under the influence of a local anesthesia, your doctor will open the abscess using a scalpel. In this method, all the hair, dirt, blood and pus are cleared from the body. The wound will then be dressed with sterile dressing. After the dressing, it is left for healing from inside out. It might take up to four weeks for the healing process to complete and most people need no further medications.

  • Phenol injection

    Under the influence of a local anesthesia, you will be injected a small dose of antiseptic phenol, inside the cyst. When administered several times, the treatment will result in the depression getting closed. With this method, the recurrence rate is very high and the practice rate is uncommon.

  • Surgical procedures

    Your doctor may recommend a surgical procedure if you have had a recurring pilonidal sinus or if you have more than one sinus tract. Local anesthesia is administered first and later, the cysts are opened to remove the pus and debris. After completion of this procedure, the wounds are stitched and allowed to heal. The stitching need to be changed regularly and the hair shaved to prevent re-growth of hair in the wounded area.

When do I contact the doctor?

Contact your doctor at the earliest, if you feel any of the above mentioned symptoms of pilonidal sinus.

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