Pilonidal Sinus Treatment

The pilonidal sinus, also known as sacrococcygeal fistula, is a small hole in the cleft at the top of the buttocks that is filled with pus. It can become a painful lump. In some cases, a patient can have multiple sinuses under the skin. Recurring pain or discomfort especially when sitting, hair protrusion from the lesion, discharge of pus or blood from the tailbone region, swollen or sore skin, etc. are some of the prominent symptoms of the condition.


  • Sitting for long hours
  • Obesity
  • Bad personal hygiene
  • Prior injuries
  • A prior history of the pilonidal sinus in family


  • Lancing : The infected pilonidal sinus is opened and cleaned. The wound is packed with a sterile dressing and given time to heal for up to a month.
  • Phenol injection : Phenol as an antiseptic is injected into the cyst after administering anesthesia. The hardened lesion is closed for healing.
  • Excision : An excision is made on the skin containing the sinus. The cavity thus created is left open to heal and to fill naturally from the bottom. The dressing is changed regularly. Healing takes up to 3 months.
  • Laser Pilonidoplasty (LPP) : In this method, a small cut is made on the skin to drain out all the pus. Then a laser fiber is used to seal the tract.
  • Z-Plasty : The abscess and sinus are removed and the triangular flaps on each side of the midline are loosened to fill the cavity. When the flaps that are in N shape are closed in the horizontal direction crossing the midline, it forms a Z shape closure.
  • Cleft lift : The infected tissues are removed leaving a cavity. The cleft is made more shallow and flatter and closed with multi-layered stitches. The new cleft allows better healing and fewer chances of getting infected.
  • Limberg flap: Those with severe pilonidal infection are recommended this procedure. The surgeon removes an oblong-shaped plug that will leave a cavity. A flap of skin and thick fat is mobilized from the buttock from the side and below the cavity and the cavity is filled. The flaps are then sutured towards the midline.

Our Doctors

Dr. Shailesh Matkar

Specialist General Surgeon



  • Does Insurance cover Pilonidal Sinus Infection Treatment?

    Yes, all Pilonidal Sinus infection surgeries or treatments are covered under the insurance plan. Consult our office to get detailed information on insurance covers for pilonidal sinus infection treatment and further recommendations. At MEDSTAR, you can also choose freely from several result-oriented and cost-effective treatment options as per your requirements.

  • Are there any side effects of Pilonidal Sinus Infection surgery?

    Laser treatment option for treating pilonidal sinus infection ensures no risk of infection, hemorrhage, or other common side effects associated with conventional surgical procedures like a recurrence of sinus or swelling.

    Other surgical options might have complications due to unhygienic conditions, straining activities, missing post-operative appointments, and medical conditions like diabetes.

  • Does Pilonidal Sinus surgery require anesthesia?

    Yes, both normal and laser surgery may require local, regional, or general anesthesia according to the severity and spread of the infection. The surgeon decides the type of anesthesia after confirming with the patient. Most of the procedures are performed under local anesthesia. In the case of general anesthesia, the patient is advised to strictly follow pre-operative instructions.

  • Is untreated pilonidal sinus dangerous?
    • It is not dangerous if the pilonidal sinus is in a dormant state without any signs and symptoms of infections. Regular shaving of hair and maintaining good hygiene is enough for it.
    • When a pilonidal sinus becomes infected resulting in a pilonidal cyst or pilonidal abscess, it needs to be treated medically without any delay.
    • If the infected pilonidal sinus is left untreated, it can result in severe painful pus discharging, infection in the buttocks, high-grade fever, and infection might spread in the whole body. Along with these symptoms, the pain will start affecting normal activities like sitting, standing, or driving.
  • Can a pilonidal sinus go away?

    Yes, pilonidal sinus can also affect women. A pilonidal sinus infection occurs due to the entrapment of thick body hair, especially coarse and curly ones. Body hair acts as a foreign particle triggering the reaction of the body resulting in the formation of a pilonidal cyst or pilonidal abscess.

  • What are the signs of pilonidal sinus infection?

    Infected pilonidal sinus can show the following symptoms:

    • Pain, redness and swelling in the tailbone area
    • Foul-smelling discharge
    • Fever
    • Lump formation in the tailbone area
    • Pain while doing normal daily activities like standing, sitting, or walking

    Consult the doctor immediately if you notice these symptoms for the treatment before the progression of infection.
  • When can I resume my daily activist after pilonidal sinus?

    The patient can start walking the same day. The patient will probably need time off work, although this depends on how you feel and the type of work you do.

    After laser surgery, the patient can join work from the 3rd day. In cases of flap surgery or have stitches, the patient can join the office after 2 weeks.

    In any case, strenuous work should be avoided for the first 2 to 4 weeks.

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