Pilonidal sinus treatment

A pilonidal sinus is a small hole in the skin near the cleft at the top of the buttocks. In some cases, there may also be a channel running from the hole beneath the skin.

Symptoms

They don’t always cause any problems and some people don’t even know they have them. But a pilonidal sinus can sometimes become infection, causing the area to become swollen and inflamed. An infected pilonidal sinus is usually painful and may bleed or produce pus and an abscess can develop beneath the skin.

Treatments

It’s often possible to treat an infected pilonidal sinus with antibiotics, although some may also need to be drained. This is usually done as a minor surgical procedure, with either local anaesthetic used to numb the area first, or general anaesthetic for larger abscesses. In both cases, you should be able to go home fairly soon afterwards (although you won’t be able to drive for at least 24 hours, until the effects of the anaesthetic have completely worn off).

Very severe or chronic problems that keep recurring may require more involved surgery to remove the pilonidal sinus entirely. This is often the best way to ensure the sinus does not keep causing problems – as these problems can have a significant impact on quality of life.

The surgery will involve removing sections of the skin on either side of the sinus, cutting out the area of skin around it, and then stitching the skin back together. If a large amount of skin is removed, plastic surgery may be required to reconstruct the area and help ensure it heals well. Your consultant will discuss what’s going to happen with your beforehand, and explain the techniques being used. The surgery will be carried out under general anaesthetic, meaning you’ll be asleep during the procedure, and you may need to stay overnight in hospital.