A pilonidal sinus (PNS) is a small abscess or cyst, which forms in the cleft at the top of the buttocks. This condition affects approximately twice as many men as women.

Pilonidal Sinus Symptoms and Treatment 

The average age for developing pilonidal sinuses is 21 in men and 19 in women, and they are less common in children and adults over the age of 45. The exact cause of a PNS is unknown.

However, certain factors can increase the risk of developing this condition, including changing hormones (because it appears after puberty), hair growth, as well as friction from wearing tight clothes or spending a lot of time in a sedentary position.

Usually, a PNS doesn’t cause any noticeable symptoms. However, if it becomes infected, it can cause severe pain, swelling, and redness in the affected area.

In the case of an infection, it may also ooze pus and blood, which have a foul odor. In case you suspect that you have a PNS, you should visit your doctor as soon as possible because the infection will get worse if you don’t receive a proper treatment.

Symptoms of a Pilonidal Sinus Infection

Initially, you may not notice any symptoms apart from an appearance of a small, dimple-like depression on your skin’s surface.

But, if the depression becomes infected, it will rapidly develop into an abscess, an inflamed and swollen tissue where pus collects, or a cyst, a closed sac filled with fluid. The symptoms of an infection are:

  • Red and sore skin around the affected area
  • Swelling of the cyst
  • Draining of pus or blood with a foul odor
  • Hair protruding from the lesion
  • Pain when sitting or standing
  • Formation of more than one sinus tract

Treatment of a Pilonidal Sinus

A PNS can be treated in different ways, depending on the severity of the disorder.

Conservative Treatment

If you don’t experience severe pain or inflammation, you will be prescribed a broad-spectrum antibiotic which treats a wide range of disease-causing bacteria.

While this won’t heal the sinus tract, it will relieve the infection and reduce the discomfort. You will be recommended to get a follow-up exam, to regularly remove the hair on the affected area, and to pay specific attention to your hygiene.

Lancing

Before undergoing this procedure, you will be given a local anesthetic. Then, your doctor will open the abscess with a scalpel in order to remove any hair, pus, and blood.

Afterward, the doctor will pack the wound with a sterile dressing to promote healing from the inside out. Usually, the wound heals within four weeks, and most patients don’t need any further treatment.

Surgery

If you have more than one sinus tract, or if you have a recurring PNS, you may require a surgical procedure. First, you will be given a local anesthetic, and then the surgeon will open the lesions to remove the debris and pus.

When the process is done, the surgeon will close the wounds with stitches. After the surgery, your doctor will explain to you how to change the dressings.

Also, they will inform you about the amount of recovery time and provide you with additional tips on how to protect the wound.