What is a pilonidal sinus?

A pilonidal sinus is a small tunnel or cyst that develops in the skin at the top of the buttocks, near the cleft. It often contains hair, debris, and skin particles, which can lead to infection, swelling, and discomfort. This condition is more common in young adults, particularly those who spend long periods sitting or have thick body hair.

What causes a pilonidal sinus?

A pilonidal sinus forms when loose hairs become embedded in the skin. Friction and pressure, such as from sitting for long periods, cause these hairs to burrow into the skin, leading to irritation and infection. Risk factors include:

• Excess body hair, particularly coarse or thick hair

• Prolonged sitting, common among office workers and drivers

• Tight clothing that increases friction in the buttock area

• Previous injury or irritation in the tailbone region

• Family history, as some people are more prone to developing pilonidal sinuses

Symptoms of a pilonidal sinus

A pilonidal sinus may start as a small, painless dimple, but if infected, it can cause:

• Pain and swelling in the upper buttock region

• Redness and tenderness around the affected area

• Pus or blood drainage, sometimes with a foul smell

• Fever or feeling unwell if the infection spreads

If left untreated, pilonidal sinus infections can become chronic and recurrent, requiring medical intervention.

How is a pilonidal sinus diagnosed?

A specialist will perform a physical examination of the affected area. In most cases, no further tests are needed, but if there are recurrent infections or complications, additional imaging may be required.

Treatment options for a pilonidal sinus

Non-surgical treatment

If the pilonidal sinus is not infected, simple measures may help:

• Keeping the area clean and dry

• Avoiding prolonged sitting

• Removing excess hair to reduce recurrence

• Using warm compresses to relieve discomfort

For mild infections, antibiotics may be prescribed, but this will not remove the sinus itself.

Surgical treatment

For persistent or infected pilonidal sinuses, a minor surgical procedure is often required. Treatment options include:

• Incision and drainage – a small incision is made to drain the infection, providing immediate relief but not preventing recurrence

• Excision and open healing – the entire sinus is removed, and the wound is left open to heal naturally, reducing the risk of recurrence but requiring regular dressing changes

• Excision with primary closure – the sinus is removed, and the wound is stitched closed for faster healing, but there is a higher chance of recurrence

• Minimally invasive surgery (pit picking or laser surgery) – affected tissue is removed with minimal damage to surrounding skin, speeding up recovery

Preventing pilonidal sinus recurrence

After treatment, steps can be taken to reduce the risk of recurrence:

• Maintain good hygiene in the buttock area

• Remove hair regularly through shaving or laser hair removal

• Avoid prolonged sitting and take breaks if needed

• Wear loose, breathable clothing to reduce friction

Why choose the Midlands Bowel Clinic?

• Minimally invasive techniques for faster recovery

• Expert colorectal specialists with extensive experience in pilonidal sinus treatment

• Personalised care plans tailored to your condition

• State-of-the-art facilities for diagnosis and treatment

Contact us

If you are experiencing pain, swelling, or recurrent infections in the tailbone area, get in touch today