Pilonidal sinus

Pilonidal means “nest of hair”. A pilonidal sinus is a small cyst or abscess (hole or tunnel) that occurs in the cleft at the top of the buttocks where they separate. The hole can be more than one and interconnected under the skin. It may become infected, and exude pus and blood and emit a foul smell.

A pilonidal sinus is a condition that mostly affects men (twice as compared to women) and is common in young adults. It is very uncommon in children and people over the age of 45.

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What Are the Causes of Pilonidal Sinus?

The exact cause of a pilonidal sinus is not known and may be caused due to a combination of following reasons:

  • Loose hair piercing the skin
  • In growing hairs
  • Injury to the sacrococcygeal region
  • Hormonal changes
  • Infection

Certain factors also increases the chances of developing a pilonidal sinus, such as

  • Obesity
  • Large amount of body hair
  • Job that involves a lot of sitting or driving.

Symptoms of Pilonidal Sinus

Initially pilonidal sinus may not cause any noticeable symptom and only a small, dimple-like depression is found on the surface of the skin. The main symptoms appear once this depression becomes infected, and quickly develop into a cyst or an abscess.
Symptoms of infection include:

  • Low grade fever
  • Pain when sitting or standing at the bottom of spine
  • Swelling of the cyst
  • Red and sore skin around the area
  • Pus or blood draining from the abscess
  • Foul smell
  • Hair protruding from the lesion
Examinations and tests

The diagnosis of pilonidal sinus starts with the doctor taking patient???s history and asking the questions about symptoms. This is followed by physical examination in which tenderness, redness and swelling between the cheeks of the buttocks confirm the diagnosis. Generally no other examination is required for the diagnosis.

Pilonidal sinus treatment

Early pilonidal sinus can be managed by sitting in warm water (stiz bath), by keeping the area clean and dry and, by removing any hair near the sinus. But as the condition progresses and infection occurs, medical treatment is required.

Medical & Surgical treatment: Treatment involves both oral intake of antibiotics and draining of pus by I&D procedure. It is a simple procedure performed under local anesthesia in which the hair follicle is removed and cavity is packed with gauze.

Laser excision of pilonidal sinus done at Vikrams clinic

Laser excision involves removal of the sinus and its tract by laser. The cavity is either left open if infection is high or else flap closure is done. The procedure is called Karydakis procedure.

Advantages of Laser excision of pilonidal sinus performed at Vikrams clinic
  • More effective than open surgical procedure
  • Relatively shorter treatment time
  • Relatively painless procedure
  • Relives the patient discomfort
  • Patient can return to normalcy in a few days??? time
  • Lesser chances of infection