Pilonidal Sinus

Overview of Pilonidal Sinus

A pilonidal sinus (PNS) also known as (Balon pe mushtimal khala /بالوں پر مشتمل خلا) forms a small sac containing pus or fluid on the cleft of the buttocks, by trapping the hair, debris, or dirt. This eventually results in the formation of a cyst or abscess.

 When the pus hole becomes infected, it may ooze pus and blood which gives a foul smell.

Mostly, PNS affects men more than women because of their hairy bodies. Also present in people who sit a lot like cab drivers.

Prevalence of Pilonidal Sinus

Globally, the infection rate of a wound is 1.5%-7%, in which the majority of the population are young, hairy males. Almost a 4% chance of the cyst may recur that remain present for 2-3 years.

Doctors Treating Pilonidal Sinus

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Signs and Symptoms of Pilonidal Sinus

At first, People with pilonidal sinus may not feel any kind of symptoms until it becomes inflamed and changes into a cyst or abscess.

The general signs of an infected sinus.

  • Pain (sitting or standing position)
  • Swollen cyst 
  • Redness, tender skin around the area
  • Discharge of pus or blood from the cyst
  • Foul smell from draining pus 
  • Hair comes out from the blister

Types of Pilonidal Sinus

Below are the two types of pilonidal sinus, depending upon the severity, persistence, and recurrence of the cysts. 

  • Acute Pilonidal Sinus (Rapid-Onset):

It occurs when pain or swelling is increasing day by day and the enclosed pus of a sac may ooze in and around the sinus. This causes pain and stiffness.

  • Chronic Pilonidal Sinus (Persistent):

In this type, the sinus may reproduce again in 4 out of 10 people after some years. But, pain is not as intense as the acute pilonidal sinus because an infected sac releases some pus. Due to this, a person feels less pain than before. But still, some infection was left in the affected area. This means that symptoms of pain and oozing of pus can stay for a longer time or cause burning until the sinus is removed by surgery. 

Causes of Pilonidal Sinus

The exact cause of pilonidal sinus is still ambiguous. Mostly the sinus appears due to the penetration of hair into the skin. Some researchers think that it can be caused by the species of aerobic or anaerobic bacteria that are: 

  • Escherichia coli
  • Proteus species 
  • Streptococcus 
  • Pseudomonas

Other stimulators that may increase the risk of sinus, include:

  • Friction and pressure on the skin
  • Tight clothing
  • Bicycling
  • Long periods of sitting

Risk Factors of Pilonidal Sinus

Here are some of the factors that increase your risk of suffering from the pilonidal sinus:

  • Poor hygiene
  • Being overweight
  • Male gender
  • Inactive lifestyle
  • Excessive body hair




To prevent sinus, these suitable steps are necessary to take:

  • Clean the affected area properly
  • Weight loss if a person is obese
  • Avoid sitting for a long time
  • Try to shave the hair from the affected area so that not to recur again


A general physician will do a physical examination of the sinus visually and identify the severity of the sinus. As such, a doctor will not recommend the lab tests.

Treatment of Pilonidal Sinus | When to Consult a Doctor

The treatment of pilonidal sinus is recommended according to its:

  • Symptoms

  • Sinus size

  • Relapse of sinus

Firstly a general physician treats the acute pilonidal sinus with antibiotics or painkillers that are used to drain the pus inside the sac-like

  • Paracetamol (painkiller)

  • Amoxicillin (antibiotic)

Sometimes a person tries to treat the cyst at home if it is not severe.

  1. Home Remedies:

The following are the preferable home remedies that people usually do for sinus relief:

  • Place the hot wet compress cloth on the cyst a few times a day. This heat helps to ooze out the pus from the cyst and relieve pain and itching.
  • A person can also take a warm, shallow bath to soak the affected area. They can also do sitz baths.
  1. Surgical Procedures:

If the pilonidal cyst is acute then a general physician will do the minor operation through incisions. It can be performed in the doctor's office. A doctor numbs the affected area with the help of anesthesia through injection. After numbing the area, the doctor pokes the pus-filled sac with a small incision to drain the cyst. After the extensive surgical procedure, it removes the cyst entirely. Then a doctor will do:

  • Leave the Wound Open: In this way, the surgical wound remains open and wraps up with a dressing to allow it to heal from the inside out. This process takes a longer healing time but typically lower the risk of recurrent pilonidal sinus.
  • Close the Wound with Stitches: In this procedure, the healing time is shorter and high risk of relapse. Sometimes, the doctor injects the incision at the side of the buttock depression and healing is quite difficult over there.

Wound healing is carefully done after the surgery, the doctors give you proper guidance regarding the normal healing process or dressing change. Also, instruct the patients to shave the hair around the surgical area to prevent hair from entering the skin.


In case you exhibit any concerning signs and symptoms of pilonidal, consult a medical professional as soon as possible.