Who gets Pilonidal sinus?
  • Young adults
  • Hairy individuals
  • People with jobs involving long sitting time
  • People with family history
Symptoms of Pilonidal Sinus
  • Acute
    Infected tract with abscess
  • Chronic
    Pus discharge
Treatment options
  • Antibiotics
  • Incision and Drainage
  • Wide Local Excision
  • Excision and Primary Closure
  • Plastic Reconstruction

Pilonidal sinus is a hole in the skin that tracks to a cavity below, occurring at the area of the top of the buttocks, where they divide (natal cleft). They are thought to form due to hair growing inwards causing infection but the exact cause is unknown.

Who gets Pilonidal Sinus?
  • They are more common in young adults and more common in men.
  • People with a lot of hair and jobs that involve sitting for a long time are more at risk.
  • Sometimes there is a family history of the condition.
What are my symptoms?
  • Acute– The track can get acutely infected and form an abscess which will present as a very painful, red lump at the top of the buttocks.
  • Chronic– They can continue to get repeated infections which subsides with pus discharge but can recur due to persistent infected cavity below the skin.
What are the treatment options?
  • Antibiotics- Occasionally the infection can be controlled with a course of antibiotics but the rate of recurrence is high.
  • Incision and Drainage- In case of acute infection when an abscess is formed it will need to be incised and drained under a general anaesthetic as an emergency.
  • Wide Local Excision- This surgery involves excising a wide area of skin and surrounding tissue involving all the tracks and the residual defect is allowed to heal by itself. This involves repeated dressing changes over a 2 to 3 week period wherein the cavity slowly heals.
  • Excision and Primary Closure- This involves excision of the skin and surrounding tissue involving all the tracts. The defect is then closed in a special way creating a flap shifting the midline cleft to one side and flattening the cleft. This reduces the healing time but is at a higher risk of wound breakdown and recurrence.
  • Plastic reconstruction- The treatment in some recurrent cases can be very challenging and may need complex reconstruction flaps to facilitate healing of the area.