V9 Hospitals

V9 Hospitals-logo

Pilonidal Sinus Symptoms, Causes, and Treatment Methods

Pilonidal sinus happens to be a condition where a cyst or even an abscess forms in the cleft at the top of one’s buttocks. Pilonidal sinus symptoms include pain, swelling, and redness in the affected area. Treatment greatly depends on the severity of the symptoms.

If there are no symptoms, then it is better to keep the affected area clear of hair while maintaining cleanliness and good personal hygiene.

If people have a pilonidal sinus, they can experience discomfort and irritation around the tailbone area.

Causes of Pilonidal Sinus

The cause of pilonidal sinus is not clear. It may be on account of hair that grows in the crease of the buttocks or a natal cleft. Also, tentatively, trapped hair follicles can lead to hair and bacteria entering one’s skin. This can result in inflammation as well as pus forming in an abscess.

Once the abscess does heal, either on its own or with treatment, a pilonidal sinus can develop. The sinus is similar to a pipe just under the skin, with tiny openings to the surface of one’s skin. People with a pilonidal sinus do need to take care of the area to prevent future abscesses and infections.

Pilonidal Sinus Symptoms

A pilonidal sinus does affect the natal cleft, which is the top of the crease of one’s buttocks, just under the tailbone.

Symptoms can range from mild to severe, depending on the level of infection. If people do have a pilonidal sinus, they can have the following symptoms:

  • Small dimples in their skin.
  • Irritation or even discomfort.
  • Painful mass, which can be an abscess.
  • Drainage from the area, which can perhaps be a clear, cloudy, or bloody fluid.
  • Fever.
  • Red, tender area.
  • Foul-smelling pus.
  • Nausea.

Pilonidal Sinus Symptoms, Causes, and Treatment Methods

Treatment options

If people do not have any symptoms or signs of infection from a pilonidal sinus, they may not really require treatment. If people do require treatment, then:

Hair removal

In minor cases, hair removal can be the first step in treating a pilonidal sinus if the infection is not present.

Hair removal options are:

  • Shaving.
  • Laser removal.
  • Waxing.
  • Epilation creams.

Research does indicate that regular hair removal and maintaining good hygiene in the area can mean reduced surgical procedures and the ability to return to normal activities. Yet, in a few cases, hair removal increased pilonidal recurrence.

People will indeed need to take care of certain hair removal techniques, like rashes or irritation.

Abscess drainage

If people have an abscess, a doctor will, of course, need to drain it. Procedures can be done at the doctor’s office.

A doctor injects a local anesthetic prior to making an incision into the abscess. This allows pus to drain away and also reduces inflammation.

Pit picking

Reducing the abscess can indeed help make the pilonidal sinus more visible and easier to treat. A few weeks after abscess drainage, people can have a procedure called pit picking. People will be given a local anesthetic and a doctor who will cut out the pit or sinus.


Antibiotics can rather reduce infection and help treat severe inflammation of one’s skin. People may have antibiotics to treat smaller abscesses.


Surgery is no doubt the most reliable method for treating and also removing a pilonidal sinus, but it can come with possible complications, like poor wound healing.

To open a pilonidal sinus, the surgeon will open up the abscess and sinus and then trim any edges of the skin. A surgeon can also remove any inflamed tissue surrounding the area.

A surgeon will then make use of healthy tissue close to the area. This method can involve a higher risk of infection, but it may be required in a few cases.


On the whole, the outlook for Pilonidal sinus symptoms need not be worrisome, as rarely long-term harmful effects are there.

A pilonidal sinus can return after the treatment, but maintaining good hygiene and removing hair from the area can help reduce the risk of it returning.

Scroll to Top