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What is a pilonidal sinus?
"Pilonidal" means "nest of hair". A pilonidal sinus forms when loose hairs are pushed into the skin of the buttock crease, usually by friction from sitting. The body treats the hair as a foreign object, and a small pit or tunnel forms around it. Bacteria can then cause an infection.
It can show up in three ways:
- Quiet pits: one or more tiny holes in the crease that cause no symptoms
- Acute abscess: a sudden, painful, hot swelling full of pus
- Chronic sinus: an opening that keeps leaking fluid or pus over weeks or months
Symptoms
- Pain or tenderness at the top of the buttock crease, worse when sitting
- Swelling and redness over the tailbone
- Pus or blood-stained discharge, sometimes with a bad smell
- One or more small pits in the skin, sometimes with hair poking out
- Fever if an abscess forms
Causes and risk factors
- Long hours of sitting: drivers, IT workers, students
- Thick or coarse body hair
- A deep buttock crease
- Sweating and friction, tight clothing
- Excess weight
- More common in young men, but it affects women too
When to see a doctor
See a surgeon if you notice a painful swelling or a leaking opening near the tailbone. Seek care the same day if you have:
- A hot, very painful swelling, with or without fever
- Redness spreading across the buttocks
- Diabetes or weak immunity along with infection signs
How it is diagnosed at Samrijo
- Examination: a pilonidal sinus is usually recognised by its typical position and pits.
- The surgeon checks it is not an anal fistula or other skin infection.
- Blood tests, including sugar, at the in-house laboratory before a procedure.
- Ultrasound occasionally, to map deep or branching tracts.
Treatment options
What to expect
Before
Examination, blood tests and an anaesthesia check. Any acute abscess is usually drained first. You typically fast for about six hours before anaesthesia.
During
The procedure is done under anaesthesia; the type is decided by the anaesthetist. Most procedures take under an hour.
After
Many patients go home the same day or next day. Keep the area clean and dry, follow dressing advice and avoid long sitting for as long as your surgeon suggests.
Preventing recurrence
Regular hair removal around the crease (laser hair removal is an option some people choose), daily hygiene, and breaks from long sitting all help.
Caring for yourself after treatment
- Keep it clean and dry. Shower daily and dry the area well. Sweat and moisture encourage infection.
- Follow dressing advice exactly. Open wounds need regular dressing until they close from the base.
- Limit long sitting in the early weeks. If your job involves sitting, take short breaks every 30–45 minutes, and ask your surgeon about a cushion.
- Remove hair from the crease and a few centimetres around it once the wound has healed, and keep doing it regularly.
- Wear loose, breathable clothes. Avoid tight jeans that rub the area.
- Come back early if you notice new swelling, pain or discharge. Small recurrences are easier to treat.
Common myths
- "It happens because of poor hygiene." Not really. Hygiene helps, but the main cause is hair being pushed into the skin by friction and sitting.
- "Once operated, it can never come back." Recurrence is possible after any method, which is why aftercare matters.
- "It is the same as piles or fistula." No. It is higher up, near the tailbone, and has a different cause and treatment.
Questions to ask your surgeon
- Is my sinus suitable for laser treatment, or would a flap work better?
- Will my wound be closed or left open, and how many dressings will I need?
- When can I sit for long hours, drive, or return to college or office?
- What can I do to lower the chance of it coming back?
Why choose Samrijo Hospital
- Several techniques under one roof, so the choice fits your sinus, not a single machine.
- Surgeon-led care by Dr. Arun Kumar Patel (MBBS, MS General Surgery).
- 24×7 hospital for a painful abscess that can't wait.
- Follow-up and prevention advice to help lower the chance of recurrence.
Cost of pilonidal sinus treatment
Cost depends on the size and type of the sinus, the technique, anaesthesia, length of stay, dressings and your insurance cover.
Call 93196 62944 for an estimate.
बुराड़ी में पाइलोनिडल साइनस का इलाज
पाइलोनिडल साइनस कमर के नीचे, नितंबों की दरार के ऊपरी हिस्से में बनने वाला एक छोटा गड्ढा या सुरंग है। लंबे समय तक बैठने से ढीले बाल त्वचा में घुस जाते हैं, और वहाँ संक्रमण, सूजन, दर्द और मवाद हो सकता है। ड्राइवर, दफ़्तर में बैठकर काम करने वाले लोग और घने बालों वाले युवा इससे ज़्यादा प्रभावित होते हैं।
Samrijo Hospital, बुराड़ी में फोड़े का ड्रेनेज, लेज़र, फ़्लैप सर्जरी और एक्सिज़न जैसे विकल्प हैं। लेज़र में आम तौर पर बड़ा घाव नहीं बनता, पर हर साइनस के लिए यह सही नहीं होता। यह बीमारी दोबारा हो सकती है, इसलिए इलाज के बाद उस जगह को साफ़-सूखा रखना और बाल हटाते रहना ज़रूरी है।
अपॉइंटमेंट के लिए कॉल करें: 93196 62944।
Frequently asked questions
Is pilonidal sinus the same as a fistula?
No. A pilonidal sinus is near the tailbone, in the fold at the top of the buttocks, and is caused by trapped hair. An anal fistula is around the anus and starts from an infected anal gland. They can look similar, so a doctor should examine it.
Can pilonidal sinus go away without surgery?
A small sinus that is not causing problems can sometimes be managed with hair removal and hygiene. Once it becomes infected repeatedly or keeps draining, it usually needs a procedure.
How long does it take to recover?
It depends on the technique. After laser or minimally invasive procedures, many people return to desk work within days. After open excision, the wound can take several weeks to heal with regular dressings. Recovery varies from person to person.
Can pilonidal sinus come back?
Yes, recurrence is common with this condition, whichever method is used. Keeping the area free of hair, keeping it clean and dry, and avoiding long hours of sitting all help lower the risk.
Do I need to stop driving or sitting after surgery?
Most people are advised to limit long periods of sitting for a while after surgery. Your surgeon will tell you when it is safe to drive or sit for long hours, depending on the procedure.
What does pilonidal sinus treatment cost?
It depends on the size of the sinus, the technique (laser, flap or excision), anaesthesia, stay and dressings. Call 93196 62944 for an estimate.
पाइलोनिडल साइनस क्या है?
यह कमर के नीचे, नितंबों के बीच की दरार के ऊपरी हिस्से में बनने वाला छोटा गड्ढा या सुरंग है, जिसमें बाल फँसकर संक्रमण हो जाता है। इसमें दर्द, सूजन और मवाद आ सकता है।
क्या पाइलोनिडल साइनस दोबारा हो सकता है?
हाँ, यह दोबारा हो सकता है। उस जगह को साफ़ और सूखा रखना, बाल हटाते रहना और लंबे समय तक एक जगह न बैठना इसका ख़तरा कम करता है।
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This page is for general health information only. It is not a diagnosis or a substitute for a consultation. Every patient is different, so please consult a qualified doctor about your own condition and treatment. Medical disclaimer.