Pilonidal Sinus – Causes, Treatment, Surgery, and Recovery

A pilonidal sinus is a tiny hole or a tunnel in the skin, at the top of the buttocks. A pilonidal sinus is filled with pus or fluid which eventually forms into a cyst. It is also known as a pilonidal cyst. And this cyst may also contain dirt, hair, and debris. A pilonidal sinus causes extreme pain, especially when it gets infected. An infected pilonidal sinus has a foul smell, and blood and pus also pour out from it.

Men and young adults are most likely to develop Pilonidal sinus. In fact, people who sit a lot are also more prone to get affected by a Pilonidal cyst.


If you or any of your loved ones have developed similar trouble, I am here to clear your doubts and tell you everything that you need to know about pilonidal sinus. Right from the symptoms, causes, and the best treatment for pilonidal sinus – this article has it all.


The exact root cause of pilonidal sinus is not yet known but there are several factors that lead to its development.

  1. The change of hormones in the body is one of the primary reasons.
  2. Activities that cause friction in the buttock area like prolonged sitting also leads to Pilonidal sinus. The clothes also cause friction, which further leads to hair growth.
  3. The hair growth in the buttock area is another key cause of Pilonidal cysts. The body considers the hair as foreign, and then sets an immune response against it. Because of it, cysts develop around the hair.


Initially, there are hardly any noticeable or significant symptoms of a pilonidal sinus. There is just a tiny dimple-like depression on the top of the area of your buttocks. But, once it gets infected, a cyst develops. The cyst will appear like a closed sac filled with fluid/pus.

Below mentioned are the signs of an infected pilonidal sinus:

  1. Feeling pain while sitting or standing
  2. A swollen and inflamed cyst on the top of the buttocks
  3. Red and swollen skin around the cyst
  4. Pouring out of blood or pus from the cyst. This may also cause a foul odor
  5. Hair growing from the cyst.
  6. More than one holes or sinus tracts on the skin
  7. A low fever is also one symptom but it is an uncommon symptom of Pilonidal sinus


Pilonidal Sinus may lead to several complications. The most common complications are:

  • Wound Infection
  • Recurrence of Pilonidal sinus
  • Unbearable pain
  • Dropping of blood and pus from the cyst/wound

Pilonidal Sinus Treatment

There are multiple treatment options depending upon the severity of the pilonidal sinus. If diagnosed early, it can be treated simply with medicines. But if it is left untreated for long, you may need surgery for sure.

Here are the treatment options for pilonidal sinus and everything you need to know about them.

The Antibiotics

  • You may simply get relief from Pilonidal sinus with antibiotics if it is diagnosed at the early stage.
  • The early stage is when you do not experience severe pain and there’s no inflammation.
  • Your doctor will prescribe you antibiotic medicines that will treat a wide array of bacteria.
  • However, this treatment does not actually treat the sinus tract. It just provides relief from the infection.
  • You will need regular follow-up check-ups.
  • You will also have to take precautionary measures like shaving the hair and paying the utmost attention to the hygiene of that specific area.

The Lancing

  • In this procedure, the doctor will open the abscess/cyst and clean away hair, blood, pus, dirt present inside it.
  • An abscess is a pus-filled sinus.
  • The doctor gives you local anesthesia and then uses a scalpel to open the abscess.
  • The doctor then cleans it by taking out all the malicious elements from it and then packs the wound with a sterile dressing.
  • The wound heals inside out within four weeks.


If the condition is severe or if it reoccurs, surgery is suggested. There are two kinds of surgical procedures to treat pilonidal sinus.

Incision and drainage: In this procedure, the doctor makes a cut and then drains out the cyst.

Cystectomy: This is another surgical procedure in which the doctor completely removes the cyst and tissues around it.

Both procedures are done under local anesthesia and cause minimal pain.


As for recovery after surgery, most patients resume normal life and daily activities within 3 weeks.  It is normal to feel a little pain and experience difficulty in doing basic activities since the wounds are fresh in the first few days. However, here are a few things that can help you sail smoothly during the recovery process.

  • Use a donut cushion to sit on
  • Get your dressings changed regularly
  • Avoid sitting on hard surfaces or for a prolonged time
  • Do not do heavy physical activities
  • Follow the doctor’s prescriptions

For a fuss-free surgery and a seamless recovery, you can get in touch with Dr. Mir Asif. His vast experience, uncountable successful surgeries, and the use of advanced medical technology make sure that the patient receives the right treatment with utmost care.


Mirascare Clinic, headed by Dr. Mir Asif Rehman, dedicatedly offers all kinds of Advanced Laser, General and Laparoscopic Surgeries. We are providing all kind of Piles/Bawaseer Treatment including Stapled hemorrhoidopexy and advanced Laser Hemorrhoids Treatment, Complex fistula Surgeries, Advanced Laparoscopic Hernia Surgery, Single Incision Laparoscopic Surgery (SILS) Gallbladder Treatment, Weight loss Surgery or Bariatric surgery, lipomas Treatment. We are dedicated to providing outstanding Surgical & Non-Surgical Care to patients.