Pilonidal Sinus Treatment in Delhi, India

A pilonidal sinus (PNS) is a small tunnel or cyst that forms near the tailbone, at the top of the buttocks. It typically develops when hair, debris, and dead skin become trapped in the skin, leading to infection and inflammation. This condition is more common in young adults and individuals with excessive body hair.If left untreated, a pilonidal sinus can cause pain, swelling, and the formation of pus-filled abscesses. In recurrent cases, surgical intervention may be required to prevent complications.

A pilonidal sinus (PNS) forms when loose hair, debris, or dead skin becomes trapped under the skin, leading to inflammation and infection. While the exact cause can vary, several contributing factors increase the risk of developing this condition:

Ingrown Hair

One of the most common causes of pilonidal sinus is ingrown hair. Loose or broken hair from the surrounding skin may penetrate the skin instead of shedding naturally. The body treats this as a foreign object, triggering an inflammatory response that can lead to a cyst or abscess.

Friction & Prolonged Pressure

Constant pressure and friction on the lower back and tailbone area can push hair and debris into the skin. Activities such as prolonged sitting, cycling, and driving for long hours increase the risk of pilonidal sinus development. People with sedentary lifestyles or jobs that require long sitting hours are more prone to this condition.

Poor Hygiene & Excessive Sweating

A moist and unclean environment around the tailbone can encourage bacterial growth, making the area more susceptible to infection. Excessive sweating, especially in individuals with thick body hair, can further aggravate the condition by trapping bacteria and dead skin cells in the affected area.

Hormonal Changes

Pilonidal sinus is more common in young adults, particularly males, due to hormonal changes during puberty. Increased oil and sweat production can make the skin more vulnerable to hair penetration and infection.

Family History & Genetic Predisposition

Some people may have a genetic tendency to develop pilonidal sinus. Factors like thicker body hair, deep natal clefts (buttock crease), or excessive sweat gland activity may run in families, increasing susceptibility.

Obesity & Excess Body Hair

Being overweight can increase the risk due to skin folds and additional pressure on the tailbone region. Individuals with coarse, thick, or curly hair are also at a higher risk, as these types of hair are more likely to become trapped in the skin.

At Max Hospitals, our team of experts focuses on identifying the root cause of pilonidal sinus and providing the best treatment options for Pilonidal Sinus treatment to ensure long-term relief and prevent recurrence.

While pilonidal sinus can affect anyone, certain factors increase the likelihood of developing this condition. Understanding these risk factors can help in early detection and prevention.

Prolonged Sitting or Inactivity

Individuals who sit for extended periods—such as office workers, drivers, or students—experience continuous pressure on the tailbone area. This friction can push hair and debris into the skin, leading to pilonidal sinus formation.

Excessive Body Hair & Coarse Hair Type

People with thick, coarse, or curly body hair, especially in the lower back and buttock area, are more prone to pilonidal sinus. Hair that sheds and gets trapped under the skin can trigger inflammation and infection.

Poor Hygiene & Excessive Sweating

Sweat and oil accumulation in the buttock crease creates a moist environment that promotes bacterial growth. This can increase the risk of infection and cyst formation. Maintaining proper hygiene can reduce the chances of developing pilonidal sinus.

Obesity & High BMI

Excess body weight increases pressure on the lower back and tailbone region, which can contribute to hair and debris getting trapped in the skin. Additionally, skin folds can create a favourable environment for bacterial growth.

Hormonal Changes

Pilonidal sinus is more common during puberty and young adulthood due to increased hormonal activity. Higher oil production can make the skin more susceptible to hair penetration and bacterial infections.

Tight Clothing & Friction

Wearing tight-fitting clothes can cause constant friction in the lower back and buttock area, increasing the chances of hair getting embedded in the skin. Loose, breathable clothing can help reduce this risk.

Family History & Genetic Factors

Some individuals may have a genetic predisposition to pilonidal sinus due to factors like thick body hair, a deep buttock crease, or increased oil production in the skin. A family history of pilonidal sinus may indicate a higher likelihood of developing the condition.

Pilonidal sinus can develop gradually, and symptoms may vary depending on the severity of the condition. In its early stages, it may go unnoticed, but as the infection progresses, discomfort and complications can arise. Recognising the symptoms early can help in seeking timely medical intervention.

Pain and Discomfort

Pilonidal sinus often begins as a mild irritation near the tailbone, but as the condition progresses, it can cause persistent pain. The discomfort worsens when sitting, walking, or engaging in activities that put pressure on the lower back.

Swelling and Redness

The affected area may appear swollen and inflamed, with redness that gradually increases. In some cases, a lump or cyst forms, which can become tender to the touch and grow in size over time.

Pus or Blood Discharge

One of the most common symptoms of pilonidal sinus is the discharge of pus or blood from the infected site. The fluid often has a foul smell and may cause skin irritation, leading to further discomfort. The discharge may also stain clothes, making hygiene management more difficult.

Visible Opening or Sinus Tract

A small hole or dimple may be present at the top of the buttock crease. This opening can develop into a sinus tract, allowing the infection to persist and return even after temporary relief. If untreated, multiple sinus tracts can form, complicating the condition.

Recurring Infections and Fever

Pilonidal sinus is known for its tendency to recur. Frequent episodes of swelling, pain, and fluid discharge indicate chronic infection. In more severe cases, the infection may spread, causing fever, chills, and general fatigue, which require immediate medical attention.

Seeking early medical intervention can prevent complications and improve overall recovery. So, make sure to consult a specialist at the first sign of discomfort.

At Max Hospitals, our doctors rely on a combination of physical examination, medical history, and, in some cases, imaging tests to confirm the condition. Here’s what to expect during the diagnostic process.

Physical Examination

Diagnosis of pilonidal sinus typically begins with a thorough physical examination. A doctor will inspect the affected area near the tailbone for signs of swelling, redness, tenderness, or a visible sinus opening. If pus or fluid discharge is present, it may indicate an active infection.

Medical History Assessment

Understanding a patient’s medical history is essential in determining the severity and recurrence of the condition. Doctors may ask about previous episodes of pilonidal sinus, lifestyle factors such as prolonged sitting, hygiene habits, and family history to assess potential risk factors.

Imaging Tests (If Needed)

In most cases, a physical examination is sufficient for diagnosis. However, if the sinus is deep or recurrent, imaging tests like ultrasound or MRI may be recommended. These tests help identify hidden abscesses or multiple sinus tracts that may not be visible externally, ensuring a precise treatment approach.

At Max Hospitals, we offer advanced treatment options for pilonidal sinus, ranging from conservative management to minimally invasive surgical procedures. The choice of treatment depends on the severity of the condition, the presence of infection, and the patient’s overall health.

Conservative Treatment

For mild cases with no significant infection, doctors may recommend non-surgical approaches such as warm compresses, maintaining hygiene, and hair removal in the affected area. Antibiotics may be prescribed if an infection is present, but they do not eliminate the sinus itself.

Drainage of Abscess

If the pilonidal sinus has formed an abscess, a doctor may perform a minor procedure to drain the accumulated pus. This provides immediate relief from pain and swelling, but further treatment may be needed to prevent recurrence.

Minimally Invasive Surgery

For recurrent or severe cases, surgical intervention is often the most effective solution. Minimally invasive procedures such as laser treatment or sinus tract excision help remove the infected tissue with minimal discomfort and faster recovery.

Excision and Flap Surgery

In complex or chronic cases, the entire sinus tract may need to be surgically removed. Flap-based reconstruction techniques can be used to close the wound and promote faster healing, reducing the chances of recurrence.

If left untreated, pilonidal sinus can lead to several complications that may affect daily life and overall health. The severity of these complications depends on factors such as recurrent infections, delayed treatment, and improper wound care.

Chronic or Recurrent Infection

One of the most common complications is repeated infections. The sinus tract can become reinfected multiple times, leading to persistent pain, swelling, and pus discharge. In chronic cases, multiple sinus tracts may form, making treatment more challenging.

Abscess Formation

An untreated pilonidal sinus can develop into a painful abscess filled with pus. This can cause severe discomfort, redness, and tenderness in the affected area. Abscesses often require drainage, and if left unmanaged, they can spread the infection to surrounding tissues.

Delayed Wound Healing

For those undergoing surgical treatment, improper post-procedure care or underlying health conditions can result in slow wound healing. In some cases, the wound may reopen or fail to close properly, increasing the risk of reinfection.

Fistula Formation

In rare cases, a pilonidal sinus can develop into a fistula, an abnormal connection between the sinus tract and nearby structures. This can make treatment more complex and may require specialised surgical intervention.

Cellulitis or Skin Infections

Recurring inflammation can lead to cellulitis, a bacterial skin infection that causes redness, warmth, and swelling. If not treated promptly, the infection may spread to deeper layers of the skin, leading to further complications.

Seeking timely treatment and maintaining proper hygiene can help prevent these complications and improve overall recovery.

Preventing pilonidal sinus involves simple lifestyle modifications and hygiene practices that help reduce the risk of developing the condition or experiencing a recurrence. Maintaining good skin care, avoiding prolonged pressure on the lower back, and managing hair growth in the affected area can significantly lower the chances of sinus formation.

Maintain Proper Hygiene

Keeping the area around the tailbone clean and dry is essential. Regular washing with mild soap and thoroughly drying the skin can help prevent bacterial buildup and reduce the risk of infection.

Avoid Prolonged Sitting

Sitting for extended periods, especially on hard surfaces, increases pressure on the tailbone area, leading to skin irritation and hair penetration. Taking breaks and using cushioned seating can help reduce strain on the lower back.

Remove Excess Hair

Hair removal in the sacral region can help prevent hair from embedding into the skin and forming a sinus tract. Shaving, laser hair removal, or using depilatory creams can be effective in minimising hair accumulation.

Wear Loose and Breathable Clothing

Tight clothing can cause friction and excessive sweating, creating a favourable environment for bacterial growth. Opting for loose, breathable fabrics can help keep the skin dry and irritation-free.

Maintain a Healthy Weight

Excess weight can contribute to skin folds and increased pressure on the lower back. Maintaining a healthy weight through a balanced diet and regular exercise can help reduce the risk of pilonidal sinus.

By following these preventive measures, the chances of developing or recurring pilonidal sinus can be significantly reduced, leading to better skin health and overall comfort.

Is pilonidal sinus a lifelong condition?

Pilonidal sinus is not necessarily lifelong, but it can become chronic if not treated properly. Timely medical intervention can help prevent recurrence.

Can pilonidal sinus heal on its own?

In mild cases, the symptoms may temporarily subside, but the sinus usually does not heal completely without medical treatment.

How long does it take for a pilonidal sinus to heal?

The healing time depends on the severity of the condition and the treatment method. Non-surgical cases may take a few weeks, while surgical wounds may take several weeks to months to heal completely.

Can pilonidal sinus affect daily activities?

Yes, it can cause discomfort while sitting, walking, or engaging in physical activities. Severe cases may restrict movement due to pain and swelling.

Is pilonidal sinus contagious?

No, pilonidal sinus is not contagious. It develops due to hair penetration and skin irritation rather than infection transmission.

Can exercise worsen pilonidal sinus?

High-impact exercises that cause friction or excessive sweating in the lower back can aggravate the condition. Low-impact activities like walking are usually safe.

What type of clothing should be worn to prevent irritation?

Loose, breathable fabrics such as cotton help prevent excessive sweating and friction, reducing irritation in the affected area.

Can a pilonidal sinus develop again after treatment?

Yes, recurrence is possible, especially if preventive measures like hygiene and hair removal are not maintained.

Does sitting for long hours increase the risk of pilonidal sinus?

Yes, prolonged sitting creates pressure on the tailbone and can contribute to sinus formation, especially in individuals with risk factors.

Is laser hair removal effective in preventing recurrence?

Yes, laser hair removal can help reduce hair growth in the affected area, minimising the chances of hair penetration and recurrence.

How should I care for the wound after pilonidal sinus surgery?

The wound should be kept clean and dry, dressings should be changed regularly, and physical activity should be limited until healing is complete.

Can I shower after pilonidal sinus surgery?

Yes, but it is important to follow the doctor's instructions regarding wound care and avoid excessive moisture in the affected area.

When can I return to work after pilonidal sinus surgery?

Recovery time varies depending on the procedure. Some patients can return to work in a few days, while others may need a few weeks, especially if their job involves prolonged sitting.

Are there any dietary restrictions after pilonidal sinus treatment?

There are no strict dietary restrictions, but a high-fibre diet is recommended to prevent constipation, which can put pressure on the affected area.

How soon can I resume exercise after pilonidal sinus treatment?

Light activities can usually be resumed within a few days, but strenuous exercises should be avoided for several weeks until full healing occurs.

Reviewed By Dr. Atul Wadhwa, Principal Consultant - General Surgery, Bariatric Surgery / Metabolic, Department of General Surgery and Robotics on 25 March 2025.