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  • Writer's pictureMumbai Piles Clinic

Pilonidal Sinus: Causes, Symptoms, Diagnosis, Treatment, and Prevention

Pilonidal sinus is a condition that affects the skin at the base of the spine. It is characterized by the formation of a small tunnel or tract beneath the skin, which may fill with pus and cause pain, swelling, and inflammation. Although it can be uncomfortable and painful, pilonidal sinus is generally not a serious condition and can be effectively treated with a variety of techniques.


The exact cause of pilonidal sinus is not well understood. Some experts believe that it is caused by the presence of hair follicles that become embedded in the skin, while others believe that it may be caused by an infection or inflammation in the area. Pilonidal sinus is more common in men than women and is often associated with prolonged sitting or pressure on the area, such as in long-distance truck drivers or people who spend a lot of time sitting at a desk.


The symptoms of pilonidal sinus can vary depending on the severity of the condition. Some people may experience no symptoms at all, while others may experience pain, swelling, redness, or a discharge of pus from the affected area. The discharge may have a foul odor and may stain clothing or bedding. In some cases, the condition may become infected, leading to fever, chills, and other signs of infection.


Diagnosing pilonidal sinus typically involves a physical examination of the affected area. The doctor may look for signs of redness, swelling, or discharge from the sinus tract. In some cases, imaging tests such as X-rays or an ultrasound may be used to help confirm the diagnosis.


There are several treatment options available for pilonidal sinus, depending on the severity of the condition. In mild cases, the doctor may recommend conservative treatment options such as soaking the area in warm water, applying topical antibiotics, or using pain relievers. In more severe cases, surgery may be necessary to remove the sinus tract and surrounding tissue.

One surgical option is called an excisional biopsy, which involves removing the entire sinus tract and any infected tissue. This procedure is usually done under general anesthesia and may require several weeks of recovery time. Another surgical option is called a closed or open wound excision, which involves removing the sinus tract and surrounding tissue, and then closing the wound with stitches or leaving it open to heal on its own. Laser laser treatment is also an option and makes use of the SILAC technique for minimal invasive treatment of pilonidal sinus and is done under local anaesthesia with no cut no pain, no blood loss and no need of dressing the patient and immediately resume work.


There are several steps that can be taken to help prevent pilonidal sinus from developing or recurring. These include:

- Keeping the area clean and dry

- Avoiding prolonged sitting or pressure on the area

- Removing any excess hair from the area

- Wearing loose-fitting clothing

- Maintaining a healthy weight and staying physically active


Pilonidal sinus is a common condition that can be uncomfortable and painful, but is generally not serious. Treatment options include conservative measures such as soaking the area in warm water, as well as surgical options such as excisional biopsy or closed/open wound excision. Prevention measures include keeping the area clean and dry, avoiding prolonged sitting or pressure on the area, and maintaining a healthy weight and active lifestyle. If you think you may have pilonidal sinus or are experiencing symptoms, it is important to speak with your doctor to determine the best course of treatment.

Dr Sambit Patnaik is a minimal invasive, laser and robotic colorectal surgeon who runs Mumbai Piles Laser Clinic located at Chembur , Kurla, Tardeo and Charni Road for laser treatment of piles hemorrhoids anal fissure and anal fistula

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