Common symptoms
- Pain or swelling near the tailbone, worse when sitting
- A small pit or hole in the skin of the buttock crease
- Discharge of pus or blood, sometimes with a bad smell
- Repeated painful abscesses in the same place
See a doctor promptly if
- A rapidly growing, hot, very painful swelling with fever
- Redness spreading over the surrounding skin
Treatment without surgery
A mild, non-infected sinus may settle with good care — and the same steps help prevent it returning after treatment.
- Keeping the area clean and dry
- Regular hair removal around the crease, as advised
- Avoiding long periods of sitting; taking breaks
- Prompt drainage if an abscess forms
Treatment options
Which option suits you is decided after examination — sometimes the answer is no procedure at all.
Abscess drainage
An infected, painful collection is opened and drained to relieve pain quickly.
Suited toAn acute abscess — usually a first step
Excision with open healing
The sinus tract is removed and the wound heals from the base with regular dressings.
Suited toRecurrent or extensive sinuses
Excision with flap closure
After removal, nearby skin is moved to close the wound and flatten the crease, which lowers the chance of recurrence.
Suited toRecurrent sinuses; quicker return to sitting
Kshar SutraAyurveda
A medicated thread may be used through the sinus tract in selected cases.
Suited toSelected cases — decided after examination
Recovery
Recovery depends on the technique: open wounds need regular dressings for several weeks, while flap repairs usually allow a return to desk work in about two weeks. Keeping the area hair-free afterwards lowers the chance of it coming back.
Insurance
Salalkar Hospital supports insurance reimbursement — you receive the bills, discharge summary and documents your insurer asks for. Many policies have a waiting period for conditions such as piles, fissure, fistula and hernia, so check your policy wording before planning surgery.
Questions
Why does a pilonidal sinus keep coming back?
Loose hair and friction in the crease can restart the problem. Choosing the right technique and keeping the area hair-free afterwards both lower the risk.
Can antibiotics cure it?
Antibiotics can help a spreading infection, but they do not remove the sinus tract. A procedure is usually needed for lasting relief.