Pilonidal Sinus: Symptoms, Causes, Treatments

Pilonidal Sinus: Symptoms, Causes, Treatments

Are you experiencing pain and discomfort due to an infected bump between the buttocks? What may appear like a small pimple can gradually escalate into a persistent and painful issue, often with recurrent infections. Now, this is the case with millions of people suffering from pilonidal sinus.

If left untreated, a pilonidal sinus leads to surgical complications and may even cause skin cancer. Fortunately, with medical advancements, laser surgery for pilonidal sinus has emerged as a highly effective treatment option.

In this blog, we will delve into what a pilonidal sinus is, its causes, recognisable symptoms and treatment approaches with a focus on laser intervention.

What is a Pilonidal Sinus?

Pilonidal sinus is an acquired condition that is characterised by the trapping of hair inside a skin fold, especially in the cleft at the top of the buttocks. The trapped hair results in a foreign reaction in the body, leading to the formation of a cyst containing dirt and debris. Over time, the cyst gets infected and forms an abscess ( a pus-filled cavity), which eventually ruptures and causes a pilonidal sinus.

Most people mistake a pilonidal sinus for a minor boil or a pimple due to their similar appearances; however, it is more than just a skin infection. It is a recurring condition and requires appropriate diagnosis and treatment.

Symptoms Indicating Pilonidal Sinus

The severity of the symptoms of pilonidal sinus depends on the level of infection. In fact, most people with this condition do not even notice any signs of it unless the cyst becomes infected. Once it progresses, the symptoms include:

  • Swelling at the bottom of the spine
  • Pain and redness
  • Redness near the affected area
  • Purulent discharge comprising pus or blood
  • High fever and chills
  • Discomfort while sitting
  • Recurrent abscess or cyst formation in the same area.

Symptoms indicating pilonidal sinus

Causes of Pilonidal Sinus

Below are the possible reasons behind the formation of the pilonidal sinus.

  • Ingrown hair: Hair growing in the skin causes inflammation and irritation, resulting in small bumps.
  • Increased friction: Prolonged friction pushes the hair inside along with dust and debris.
  • Skin: Minor cuts in the buttock area, making it easier for hair and debris to trigger an infection.
  • Genetics: Some individuals are genetically predisposed to developing a pilonidal sinus.

Who is More Prone to Having Pilonidal Sinus?

Dr. Purnendu Bhowmik, a reputed doctor for carrying out laser surgery for pilonidal sinus, lists the following factors that make a person predisposed to the condition.

Male sex: Males are significantly more than women.

Age: Particularly younger people in their 20s

Obesity: Excessive weight increases skin folds and friction.

Jobs: Occupations requiring prolonged sitting, such as desk workers or drivers.

Excess body hair: Especially in the lower back region.

Stiff or coarse hair: More likely to get trapped in the skin

Poor hygiene: Increases the risk of infection.

Failing under these risk factors does not mean that you are going to develop a pilonidal sinus; however, it increases the chance of its occurrence to a great extent.

Can a Pilonidal Sinus Heal on its Own?

Although rare, in mild cases, a pilonidal sinus might temporarily close on its own with conservative care like proper hygiene and hair removal. But most tend to recur again, causing pain and swelling.

Surgical intervention is needed to get permanent relief and prevent complications. Hence, make sure to consult an experienced surgeon for evaluation and to determine the best treatment approach.

Diagnosis of Pilonidal Sinus

Diagnosis of pilonidal sinus begins with a physical examination. Your healthcare provider will look for signs of swelling, redness and discharge near the affected area. They might also ask about the patient’s medical history.

If the diagnosis remains unclear, patients are recommended to undergo imaging tests like an MRI to identify the severity and extent of the sinus.

Treatment Options

Surgeons employ many treatment modalities to treat the condition. The approaches are categorised into the conventional method and laser surgery for pilonidal sinus.

Let’s discuss each of them.

  • Simple incision: A cut is made in the cyst to drain the pus and fluid. It is done under anaesthesia.
  • Excision: It involves removing the sinus tract along with some surrounding tissue to remove the sinus. The wound is then closed with stitches.
  • Plastic surgery techniques: It usually involves flap procedures, where skin and underlying tissue are reconstructed to flatten the cleft and prevent further accumulation of hair and debris.
  • Marsupialisation: It is a surgical intervention where the sinus tract is removed and the wound edges are sutured for drainage.

The above methods require a longer hospital stay, regular dressing, and a delayed recovery period. There is even a higher chance of infection and postoperative discomfort.

Laser Surgery For Pilonidal Sinus

One of the advancements in the treatment of pilonidal sinus is laser surgery.

Laser surgery for pilonidal sinus is widely used due to its minimally invasive nature and quick healing. During the procedure, laser beams are used to destroy the sinus tract, allowing it to close naturally without the need for any large incisions.

Benefits of Laser Surgery for Pilonidal Sinus

Laser surgery for the pilonidal sinus has several advantages. Here are some of them.

Minimally invasive: The procedures do not require larger incisions. It is done through small cuts.

Outpatient procedure: It takes only 30 minutes to 1 hour, and patients are discharged on the same day.

Faster recovery: The recovery period is short, and patients can resume their daily activities within a few days.

Less pain: There is no tissue damage, and hence there is less pain and blood loss.

No risk of infection: The chance of operative infections is minimal.

Minimal scarring: There are no visible scars or marks after the procedure.

High success rate: The majority of patients reported successful recovery with no recurrence cases.

Post-Operative Care

Post-operative care is important after laser surgery to ensure safe and quick healing. During this time, patients are advised the following:

  • Make sure to keep the wound area clean and dry.
  • Avoid sitting for prolonged hours. If required, take small breaks in between.
  • Maintain proper hygiene and remove hair from the area.
  • Take the medicines regularly as prescribed by the doctor.
  • Attend all the scheduled appointments to let your surgeon monitor your progress.

Final Words

Knowing the symptoms of pilonidal sinus and understanding the available treatment methods is necessary to get relief from the condition. While traditional treatment approaches are still used, laser surgery for pilonidal sinus has become quite popular due to less pain and faster recovery. If you are dealing with a pilonidal sinus, consult a surgeon to discuss whether laser surgery is right for you.