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What is Pilonidal Sinus?

A sinus is a tunnel or channel under the skin. A pilonidal sinus is a sinus that is commonly formed above the natal cleft (the crease where the buttocks separate). A pilonidal sinus usually contains hairs and may get infected to form a cyst or an abscess (collections of pus). “Pilonidal” directly translates to “nest of hairs” (pilus=hair and nidus=nest).

Pilonidal sinus treatment depends on the severity of the symptoms, the sinus size, and whether the condition is recurrent.

What are the Symptoms of Pilonidal Sinus?

The initial stages of pilonidal sinuses are usually asymptomatic. When it gets infected and a cyst or an abscess is formed, symptoms are presented.

Common symptoms include:

  • A lump formed near the natal cleft (crease where the buttocks separate) which may have protruding hairs
  • Pain in the area while seated, standing up, or both
  • Redness or inflammation (swelling) of the area
  • Discharge of pus or blood, often with a foul odour

In some cases, you may develop a fever indicating the presence of an infection.

When Should You Seek Medical Help?

If you are experiencing the listed pilonidal sinus symptoms and think you may have a pilonidal sinus, it is best to seek treatment as early as possible. Infected pilonidal sinuses do not go away on their own and may require emergency drainage. Leaving it untreated can lead to worsening symptoms, a negative effect on your daily activities, and potential complications.

Early medical intervention can facilitate easier treatment options and a speedier recovery. Many suffer in silence from pilonidal sinuses because they are hesitant to see a doctor. Our team of specialists is professional and well-experienced and will put you at ease throughout the process.

What Causes Pilonidal Sinus?

Causes of pilonidal sinuses include:

  • Ingrown Hairs: 

These are hairs that grow in the wrong direction, into the skin, and cause irritation of the skin. Improper execution of hair removal in the area might be to blame for this.

  • Skin Irritation and Infections:

A pilonidal sinus can develop as a result of irritation and infection of the skin in the area due to friction, prolonged sitting, etc.

Some risk factors that may make you more susceptible to developing a pilonidal sinus are:

  • Obesity
  • Excessive hair growth in the area
  • Deep natal cleft (crease where the buttocks are separated)
  • Prolonged sitting
  • Sedentary job
  • Family history
  • Hormone changes, like puberty

Pilonidal sinuses affect men more than women and are seen most often in young men. It is rare in children and individuals over the age of 40.

How is a Pilonidal Sinus Diagnosed?

After going over your symptoms and medical history in detail, the doctor will examine the affected area. Since pilonidal sinuses are externally visible, a visual examination usually suffices for diagnosis. Imaging tests and blood tests may occasionally be required to ascertain the presence of an infection and determine the severity of the condition.

What are the Treatment Options for a Pilonidal Sinus?

Asymptomatic cases of pilonidal sinus can usually be managed without surgery by keeping the affected area clean, dry, and free of excess hair. 

The most effective treatment option for an infected and symptomatic pilonidal sinus is surgery. While antibiotics or other medicines can be used to manage its symptoms, treating pilonidal sinus without surgery does not cure the underlying cause or prevent it from recurring.

1. Curettage and Drainage Surgery of Pilonidal Sinus

In Curettage and Drainage Surgery, infected tissue in pilonidal sinus disease can be cleaned under general anaesthesia (you will be asleep during the procedure). A plastic tube (seton) is inserted to reduce pain and prevent collections of pus in the natal cleft between the buttocks. This offers quick relief and prevents repeated pain and the collection of pus. This procedure can be followed up later with less invasive procedures, such as laser ablation.

➡️ Learn more about Curettage and Drainage Surgery

2. Excision and Primary Closure Surgery of Pilonidal Sinus

Excision and Primary Closure Surgery is an elective procedure under general anaesthesia. The pilonidal sinus is excised (cut out) and the defect (hole) is sutured (sewn) together in a single surgery. This offers a single surgery. The drawback is the area of the wound (near the natal cleft), which is moist and moves frequently. This results in the wound often breaking down, which can lead to prolonged dressing changes and a wound that can be unsightly.

➡️ Learn more about Excision and Primary Closure Surgery

3. PiLAC (Pilonidal sinus Laser-Assisted Closure) Procedure

Our surgeons have excellent results in treating pilonidal sinus with laser ablation. Pilonidal sinus Laser-Assisted Closure is a minimally invasive surgical technique is performed under anaesthesia and uses laser energy to destroy the infected tissues. It has the benefit of not creating any wounds that might break down and require dressings and time off work. It may require an initial curettage and drainage procedure if the tissues are very infected, but both procedures do not require time off work or daily dressings by a district nurse in most cases.

The doctor will discuss the pros and cons of each procedure which will enable you to make an informed decision. You can get answers to any questions or concerns you may have during this discussion.

➡️ Learn more about Pilonidal Sinus laser Surgery

Why Choose the Leicester Bowel Clinic?

Book a consultation with us to get treatment for your condition.

At Leicester Bowel Clinic, we focus on bowel health and conditions, digestive issues, and cancer care. Our clinic offers minimally invasive procedures for bowel problems, ensuring effective results and patient comfort. We aim to provide personalised care for our patients and offer the latest treatments for hernias, bowel conditions and rectal disorders.

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  • Wednesdays evenings (Mr Runau) from 6:00 pm until 9:00 pm at: Spire Leicester Hospital Gartree Road Leicester LE2 2FF
  • To arrange an appointment directly with the Spire Leicester Hospital, please call the booking line on 0116 2653685

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Frequently Asked Questions

01. Is it OK to live with a pilonidal sinus?

Living with pilonidal sinus can be a difficult ordeal. While they may be asymptomatic initially, there is a high chance of infection and cyst or abscess formation, which collects pus. This causes symptoms that have an impact on your daily activities, often escalating quickly. If you start experiencing symptoms of an infected pilonidal sinus, you should consult a doctor to get it treated as soon as possible.

02. Can pilonidal sinus be treated with over-the-counter medications?

While some over-the-counter medications can be helpful in the management of symptoms, they cannot cure the underlying cause or prevent pilonidal sinus from recurring. Instead of neglecting your symptoms and putting off treatment, it is recommended that you consult a doctor as soon as you can for a precise diagnosis and appropriate treatment.

03. Is there a permanent cure for pilonidal sinus?

Surgery with complete removal of the sinus tract offers the best chance of a permanent cure. However, even surgeries carry a small risk of recurrence.