Pilonidal sinus

Date: 14 Oct 2013

By: admin_campbell

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Causes of a pilonidal sinus
complications
Complications of a pilonidal sinus
Diagnosis
Introduction
Symptoms of a pilonidal sinus
Treating a pilonidal sinus

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Pilonidal sinus

Causes of a pilonidal sinus

[Original article on NHS Choices website]

The exact cause of pilonidal sinuses is unclear. It is generally thought they are caused by loose hairs that push into the skin.

There are several theories as to how this could happen.

Hair follicles

Hair follicles are the small holes that an individual hair grows out of. It is thought that pressure and friction on a hair follicle could somehow damage it, causing a pilonidal sinus.

If a hair follicle becomes blocked, it can become enlarged and then burst. A broken hair may push into the skin, leading to an infection.

This may explain why pilonidal sinuses are common around the buttocks, as sitting and driving will cause pressure and friction on this area.

There have been reports of hairdressers developing pilonidal sinuses on their hands. This may be caused by hair becoming trapped in moist, damaged skin between a hairdresser’s fingers.

Infection of the pilonidal sinus

If a broken hair pushes into the skin, the skin becomes irritated, red and swollen. Bacteria can quickly infect this skin. The cleft between the buttocks is an ideal place for bacteria to spread, as it is often moist and warm.

When the skin is infected, the immune system (the body’s natural defence against infection and illness) tries to fight the bacteria, which results in a collection of pus known as an abscess.

Increased risk

Some things are known to increase your risk of pilonidal sinuses, including:

obesity – having a body mass index (BMI) of 30 or above
age – pilonidal sinuses can occur at any age, but are more common in young adults between the ages of 20 and 40
having an above average amount of body hair, which may be why more men are affected than women
having coarse and curly body hair
a previous injury to the affected area of skin, for example from a fall
having a deep cleft between your buttocks
having a family history of the condition – more than one-third of people have a family member with the condition
having a job that involves a lot of driving or sitting down for long periods

Jeep seat

During the Second World War, thousands of army jeep drivers developed pilonidal sinuses. The condition became so widespread that it was nicknamed “jeep seat”, or “jeep disease”.

The fact that so many men doing the same sort of job developed pilonidal sinuses suggests that environmental factors must play a role in the development of the condition. These factors could include:

wearing restrictive clothing, such as army uniforms
repetitive motion, such as bouncing around in the seat of a jeep

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Published Date: 2013-08-06 10:22:48Z
Last Review Date: 2012-11-20 00:00:00Z
Next Review Date: 2014-11-20 00:00:00Z

Classification: Pilonidal sinus

Pilonidal sinus – NHS Choices

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Pilonidal sinus

Overview
Pilonidal-sinus Clinical trials

Introduction

Pilonidal sinuses commonly occur at the top of the buttocks

Who is affected?

Pilonidal sinuses are rare, affecting about 26 in 100,000 people each year.

Pilonidal sinuses affect at least twice as many men as women. The average age for a pilonidal sinus is 21 in men and 19 in women. They are less common in children and people over the age of 40.

A pilonidal sinus is a small hole or “tunnel” in the skin. It usually develops in the cleft of the buttocks where the buttocks separate.

More than one hole may develop, and often these are linked by tunnels under the skin.

Most people associate the word sinus with the nose, but sinuses can occur anywhere in the body. Sinus is simply a medical term for a channel or cavity.

A pilonidal sinus will not usually cause any noticeable symptoms unless it becomes infected. This can cause a pus-filled abscess to develop. Signs that you may have an infection include pain, redness and swelling in the affected area.

See your GP as soon as possible if you think you have a pilonidal sinus. Without treatment, any pain and infection may get worse.

Your GP should be able to diagnose a pilonidal sinus after carrying out a visual examination of the affected area of skin. Further testing is not usually required.

Read more about the symptoms of pilonidal sinus.

Why do pilonidal sinuses happen?

The exact cause of a pilonidal sinus is unclear, although it is thought to be caused by loose hair piercing the skin. The term “pilonidal” is Latin for “nest of hairs”.

Certain things can increase your chances of developing a pilonidal sinus, such as being obese, having a large amount of body hair and having a job that involves a lot of sitting or driving.

Read more about the causes of pilonidal sinus.

How are pilonidal sinuses treated?

If you have a pilonidal sinus, it is important to keep the area clean and dry. It may also help to remove any hair near the sinus. These steps can reduce the risk of infection.

Showering at the end of the day to remove hairs fallen from your head or back into the cleft between your buttocks may also help.

If a pilonidal sinus becomes infected, it should be treated as soon as possible, as it is likely to get worse.

You may initially be treated with antibiotics, but you will also need to have the pus drained out of the abscess during a minor surgical procedure called incision and drainage.

If it keeps becoming infected, surgical removal of the sinus is usually recommended. Several techniques can be used to do this, including:

cutting out the sinus and leaving the wound open so it can heal, and packing it daily with a dressing
closing the wound with a flap of skin and stitches
scraping out the sinuses and filling them with a special glue

It is important to carefully look after any area of skin that has been operated on, as there is a chance you will become infected again. This involves things like regularly changing dressings and keeping the area clean.

Read more about treating pilonidal sinus.

Page last reviewed: 20/11/2012

Next review due: 20/11/2014

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Comments

The 75 comments about ‘Pilonidal sinus’ posted are personal views. Any information they give has not been checked and may not be accurate.

momal35 said on 30 September 2014

I was told yesterday I have PS by doctor, it came as a shock as I asked a friend what is there, and they gasped and went you got deep hole there, so went GP emergency app and she said it looks like it hasn’t got to a abscess yet and is small size and could heal up with two different antibiotics, to use for one week then go back for check up. But now reading other peoples experiences I guess its something I have to deal with and can expect it to come back, I find it hard to sleep at night due to this and my coccyx issues for many months due to my heavy weight. I was told keep it clean shave hair maybe every weeks or seek laser hair removal. This will be a big problem for me as I suffer with poor hygiene along with long term depression and find it hard to motivate to clean, Please see doctor asap if you think you have the same disease, many factors contribute being hairy, overweight, long sitting, hair ingrowing. If you do not have any symptoms of this and just doing research I would recommend you shave off hair in this area to hopefully prevent you to become unwell

RainbowHorror01 said on 17 September 2014

I’m 15 years old and been suffering from this for two years now, a year of which was simply going back to the doctor and telling them that the antibiotics they have given me weren’t working on my supposed ‘granuloma’ which I now know was a mis-diagnosis. I’ve had it removed twice surgically; once on local anaesthetic at the hospital and again in March 2014 on general anaesthetic. Even though I now how permanent surgical scarring(including stitches scarring) I’ve now been told that it has recurred and that I’ll require another, deeper general anaesthetic operation in the next 3-5 weeks. I’ve lost count of the days missed of school, the antibiotic treatments given, and the stitches removed and still have to face the ridicule and humiliation of being a 15 year old girl with a typically male disease, of having male doctors examining me and not being able to tell my friends about why I’ve been in hospital for two days, not to mention the pain of the cysts that form.
This is a serious disease, and should be treated as such.
I can only hope that this is the last time I’m under the knife.

Tgbailey77 said on 16 September 2014

I had a lump for many years and being a male ignored it! I was never in much pain but when I eventually sought medical advise I was told an operation was needed. I was told little about the procedure and naively thought ild be back playing sport in a few weeks, let alone still off work.

I was originally stitched up after my operation and 10 days later they burst when I leaned forward…great back to square 1! I know have to have my newly formed home dressed every day and to this day can’t really sit or exercise.

Anyhow 4 weeks later I’m still off ‘sick’ despite feeling fine in myself and guilty for not having ( in my words) a real illness, although I’m assured this is serious and not treated correctly it very much could be.

The nurses have been great, my only grip is I was never told what the procedure would entail, how long I may be off work or even now when can I go back, drive or exercise…..I’m told it’s a waiting game and it takes as long as it takes as everyone is different.

My advise would be to pre warn your employers that you may be off work for some time and until operated I’m afraid you don’t know how long.

Hswatkins said on 08 September 2014

I had my first experience of this abscess a few weeks ago. I’m a 22 year old who has been overweight from a sediatry student lifestyle and began getting into fitness over the last 6 months. I work in a very active environment and where I go to the gym every day, sweat a lot. So I can only assume the culmination of these factors caused the abscess. I had been on night shifts and couldn’t sit down properly and was in a lot of pain. The following morning I was woken up while lying on my front from the excruciating pain. Called the gp who recommended I go to a&e, did so, was sent home with antibiotics as the abscess was not soft enough. The following day the abscess ruptured and began draining (relief!) but I called nhs 111 and was recommended to go to a&e. Had a very severe infection that made me completely disorientated and sick (but was not triaged due to the referral from 111 – so ended up waiting with the screaming teenagers and their impatient patients while I’m curled up trying not to vomit). Was admitted straight away and given very invasive iv antibiotics as I was very poorly. Surgery done that night (Saturday night). Discharged the following day. The pain from the abscess was obviously gone. But the wound was 8cm deep and 2cm wide, so repacking caused me enough pain to make me want to be sick. Had it packed once by the gp surgery nurse and had my mother repack it subsequently as I work in hospital and my mother was a veterinary nurse. I recommend anyone who has common sense and a willing loved one to pack these wounds yourself. So long as you understand the basics of wound care and if you notice any changes, see your doctor, it really did make the process less distressing. For anyone who is active to then feel completely caged off, it’s very hard!

The antibiotics I was given (amoxicillin and metronidazole) the latter made me quite unwell (migraines, tiredness and constantly feeling sick) and in comparison to the pain of the abscess and repacking…

Saralucy92 said on 16 April 2014

I have had 4 drainage & incisions now and I went to the hospital and he wants me to have the wider excision operation but I’m not sure if to take the chance or not as he said it might not get rid of them what do people think? X

Millak said on 06 April 2014

I have suffered with these things for around 15yrs now and they are quite literally a pain in the bum!!! After undergoing no other than 7 surgical procedures and none of them really working I am left with a sinus that flares up thankfully not too often! I am currently suffering quite a bad infection in the area and have 3 drain holes in the skin, luckily I work with some fantastic nurses who use their knowledge and expertise to help ease my pain and dress the area daily for me which in turn enables me to carry on as normal. To anyone who has never suffered with these who say "it can’t be that painful" believe me (and I’m not a baby where pain is concerned) the pain of one of these things is worse than child birth it’s constant persistent pain and no matter what you do it hurts!!!! Now to you fellow sufferers after years and years of suffering I find that showering twice daily and drying the area thoroughly helps reduce the occurrence of these flare ups! Good luck to you all with these and if you vote for surgery I really do hope it works for you!

meganmolly said on 20 February 2014

My son had a pilonidal cyst in March 2013.
It came on very quickly and within 2 days he was having surgery.
His wound was left open and then started the chore of having to go to a walk in clinic or GP’s surgery every day for wound dressing.
No District Nurse for him, even though he also had a slipped disc and was in great pain because of that.
Having to sit for hours in a waiting room, for the dressing to be done was taxing to say the least.
The wound was very slow to heal and in the end he was resigned to it never healing up completely.
He had to have surgery in September 2013 for his slipped disc.
Shortly after that he had pain and swelling in the wound site of his PS, he went to the GP and was given anti-biotics, the GP said the wound was completely closed, it was just a slight infection of the wound edges. The anti-biotics worked and he seems to be well at the moment with no ongoing issues with PS.
I hope this is the end of PS for him and I do hope others on here have a good outcome too.

soundz said on 19 February 2014

I had surgery at the end of march 2013, had to pack it for a fair few months after making regular trips daily to the doctors. It started to come back next the the hole from previously around 2-3 months ago and Ive put up with it since. I have been to the doctors and they gave me antibiotics to take which havent helped. It has come back in two spots now and has recently been pussing and leaking regularly. I know its not what anybody wants to hear but it isnt something that just goes away. Most people and everybody I know who has had this are in the same boat and find it flares up after surgery. My best advise, get it looked at and use a hot water bottle to bring the head out. Also be prepared, as sittings normally isnt going to be happening any time soon without a lot of pain.

poil said on 28 December 2013

@Mkhan87, I had mine operated on about four months ago and it went very smoothly. I had the small "sinus" hole in the cleft of my buttocks just as described here and didn’t go to my GP until it actually started seeping and the pain was unbearable. My GP used a local on my buttocks which was the most painful part of the experience but no tears so wasn’t too bad. He actually cut in the cleft and accessed the abscess from the side and removed hair and any other debris and then scraped the tunnels to prevent further issue and also to promote scar tissue. I have the "open healing" method and i still have a small hole after four months. I am unsure how it will ever close entirely because of the constant movement in that area but as long as I shower and keep debris out of the hole everything’s fine. I can bike and run just fine. I was able to exercise maybe two weeks after my operation. I took it slow though because I didn’t want to risk making it worse. So I would avoid running for a good while until you feel comfortable enough without dressing around the hole. That’s another thing, I do not use dressing so long as I keep the area clean. The hole is small enough that at the end of each day I can easily clean out lint or hair from the area before it migrates further. My GP mentioned sewing it up if I really needed it done. So if you decide you can’t live with a small hole that required some cleaning or just don’t want to worry about it, I would return after a few months of leaving it open to have it closed up. I think leaving it open at first anyways is a good idea because it gives it time to air out and drain completely. Overall, after four months I am quite comfortable and all that remains is a small hole which only get’s red and irritated after a lot of exercise . But after resting and a nice bath or shower it is fine. If it stays irritated just use some dressing and keep it clean for a day or two and everything’s peachy.

Mkhan87 said on 23 December 2013

I was doing my session in the gym and after the session I went to take a shower and I noticed my underwear full of blood. I started panicking but after examining it by myself I thought it is a minor injury which would heal sooner.But after two months again I had bleeding then I had to see my GP and he told my about this disease. Now It bleeds everyday, the area is not painful but It bleeds now al the time and I am waiting for the hospital appointment which is 9th of January. I am not sure what they would do with it, but I really want to get it removed by surgical operation. Can anyone please guide me doest it get better after operation? for how long I would be able to do running/gym session after the operation? does the wound recover completely after the operation?

londoner80 said on 13 December 2013

Does this ever clear up with just antibiotics & drainage? I’ve only just noticed a bit of swelling & discomfort in the last couple of days & have been put on antibiotics today & am petrified after reading of all the (repeated) surgeries here. Is it inevitable or only cases where its been left untreated for a while?

Tomothy Terrific said on 12 December 2013

Well, after my operation on 4/12/13 I went back to work on 7/12/13. The doctor want sure but I get it packed daily before work and have had no issues at all, i’m so happy I got it sorted out as soon as I could. If anyone has amy concerns go to your doctor straight away, and to those of you that do suffer complications you have my sympathy but hang in there 🙂

“Aftera storm there is always a chance for freshness and growth”

Tomothy Terrific said on 06 December 2013

After commenting on 3/12/13 my pain became unbearable so I went to local walk in centre on 4/12/13 was sent to hospital and spent the day there and had a wide excision, started on my daily packing which I am not a fan of but as of yet no more pain just slight discomfort from certain sitting or lying positions, although I was reluctant to go for the operation i’m glad I did, just need to see how this lovely wound heals now.

I’ll keep you posted on everything 🙂

"laughter is my favourite drug"

Tomothy Terrific said on 03 December 2013

Hi,I am 22 and this week started an new , however I have noticed that the lump that I have has become red inflamed and really painful so much so that it affects my walking and sitting. after reading about it I am absolutely terrified of having time off work and the while wide excision rite fills me with dread, can someone suggest anything I can do before seeing a doctor or is that our only option.

Thanks 🙂

“Even if you don’t feel like it, smile, it helps maker others feel better.”

jessie77 said on 06 November 2013

About every 4 or 5 months mine flares up, I don’t know what starts it off. It’s flared up now, its very itchy and sore. Couple of yrs ago I saw a doc at hospital and he had a look at it. Unfortunatly by the time he saw it ,it had gone down and he said there was nothing he could do but to come back and see him when it flares up again!

I saw a gp the next time it flared up and asked her about having an op but she said its too small for an op. Funny cos last time she said if it flared up again I could have an op on it! She just gave me some cream to put on it,which did kinda help.

Now its flared up again, I wonder what the gp will say this time when I go back to see her.

Leonna9 said on 19 September 2013

In reply to Arctichelen_

Your situation sounds very similar to mine, I had the district nurse out for 3 months in total until it was at a stage that it didn’t need specialist attention. At many points during my aftercare it was painfully sore and there were numerous occasions where we thought it could be infected. A lot of the time it wasn’t and it was just where It was badly infected to begin with it takes so long for all the infection to draw out and that was what was the weepyness etc.
I also was in a situation where my surgeon said it was the worst thing he has seen in a long time from the 10am of being in a & e to the 10pm that night it had tripled in size.
My only advice may seem odd however if you are having so many problems and it is infected this can often help toward the decision to give you the bascoms procedure which is not 100% guaranteed but I was very fortunate to be given it after my first drainage most people have to get about 5 before they qualify and it was all the aftercare problems I had that led to that choice. I am now free of pain and was given reconstructive surgery on my original scar.

Hope it gets better for you.

Arctichelen_ said on 16 September 2013

I am 17 and 3 months ago I experienced my first PS. I ignored it for about 4 days and when I went to the doctor he said that it was the most infected thing he had ever seen. I had an operation on it that night.
I was supposed to be discharged from my district nurse who used to come to me everyday to pack it but it has become sore again. Since going back to school, I have had to sit down for long periods of time which is now impossible. My nurse came today and said that it should not be like this at this stage. I am really worried that I have an infection or what has healed will break down.

plumtuckered said on 13 September 2013

Hello, maybe this will help some of you, I do hope so. Have had 2 ops for this now, which ment 2 ruined summers so was panicking when told it may happen again. So I managed to work out that laying on either side even just for a little while seemed to start it off. So now I never lie on my side and sleep on my back every night which has worked like a little miracle. Hope it’s helpful to someone out there.

teapotcfj said on 25 June 2013

I had a PS 45 years ago and it was cut out then, hey-ho its come back again, weeping like a good one but surprisingly not painful as of yet. GP will advise the best course of action but there isn’t anything much to cut out.

Leonna9 said on 20 June 2013

Hi to all, I have wrote on this a few times during my issues with PS and I am now at a stage where I am fully heeled.
I was fortunate enough to have the bascoms op very shortly after my first ever drainage. Something I would say to all people who are going for this and are worried about packing etc is that I was lucky that my surgeon decided to monitor me closely to pick a time slot when I was free from infection, in most cases this means that they can close you up. I was so lucky that during my op the surgeon very kindly also did reconstructive surgery on the area. My sinus was so large that it would have left such a huge diffrence in size that they managed to cover over all my previous hidous scarring that was causeing from secondary healing in my emergency case. Ive been through the packing and it absalulty awful I feel for those of you who are still going through it at this stage. You will almost never get a nice scar from it. My advice is to push your GPs and surgeons etc because now you would never know that id ever had the operation. To those of you who think you have one get it checked out my came on over a matter of 72 hours and they said had I have left it any longer I would have defiantly got Septacemia. It can be very serious.

Lollibob said on 16 May 2013

I had my first operation in November after 20 years of pain. I then had my second in January where they closed it up but didn’t add a drain so the wound broke down after a couple of days. After 4 months I’m and still going to the doctors everyday to be packed I’m now really ill again and looking at going back in very soon which I’m not looking forward too. Safe to say I’m fed up. The only consolation is that all of my nerves were cut and I still have no feeling in it.

berniethebolt said on 25 April 2013

To WOOSIE Apr 13…. May i ask where you had your bascom’s op done? Thank you.
My son going in to have surgery Friday and been told it will probably be open and packing, the results of which, as a nurse, i’m not finding particularly reassuring! Have mentioned the other methods to him to enquire about but don’t know whether every surgeon would do this and he didn’t get far in raising it as an option!
Many thanks.

woosie42 said on 23 April 2013

I had two operations done to remove my sinuses.
In january 2011 i had a third one appear and it had popped and was oozing out of the would.
Went to the doctor and was referred to the local hospital and was told about the boscom cleft precedure.
I had it done in the february where they had scraped the diseased tissue out and created a flap over the upper crease of my bottom to prevent it coming back.
I had a drain in for a week no daily dressings which was a god send!!
The area healed very quickly and to this date 23/04/2013.
I have had no problems and no more signs of it returning.

seanysinus said on 19 March 2013

I had the operation to excise my Pilonidal Sinus on the 12th of Feb’ this year after having suffered with the problem since February of last year.
The procedure went very smoothly and I was left with a 6 by 1cm diameter excision that was 3cm deep in my lower cleft about 2cm from the anal verge so quite lower down than most people normally have from what I’ve seen.
In the month and 1 week since the operation I’ve not experienced any pain that I would called agonising just soreness & tenderness when the packing is done daily. I’ve found if I time when I take my painkillers & listen to my ipod while deep breathing when they do it, it keeps my mind off the pain. I’m no longer on co-codomol & just use paracetamol with ibuprofen to help ease the throbbing.
I’ve encountered some problems in that it’s been just over a month since the operation now & apparently the wound bed has reduced from 3 to 2cm but there is still alot of bleeding coming from the wound somewhere. I have to visit the surgeon that did it on Friday as the nurses referred me because they suspect a surface vein or capillary my have been severed & is causing the bleeding. If this is the case it will probably need cauterizing.
Has anyone with this condition had this problem with bleeding post surgery? If so did you have to get part of the wound cauterized and what does it involve?

User752510 said on 01 March 2013

My situation: I had my op in late December 2012 after dealing with the infected ps cavity for about 10 months. I am a university student and had the op during the Christmas break so i had the luxury of not having to do much for a few weeks.

The op: It went fine and was painless for the first few days. I had an 8cm long, 2.5cm deep open wound from the top of my buttocks downwards. I was put under general anaesthetic but it was very quick and afterwards I felt like nothing had even happened.

Daily packing: Packed everyday for however long the doc says. For me it was 3 weeks. The pain of re-packing depended on the nurse I had. The actual packing of the hole was not particularly painful everyday it was just the cleaning of it that would smart a little bit. Some nurses were dreadful at it, with others I could barely feel a thing 🙂

Recovery: Not much pain just walking around everyday. I just felt like a big bruise. Sitting down was painful between week 1 and week 4. I was restricted to laying on my side for 2-3 weeks as normal sitting would stretch the wound.

At university I am getting a dressing changed around 3 times a week instead of everyday like before. However the healing has definitely slowed down since I’ve had to sit down for long periods to do work, lectures etc. Overall 10 weeks have passed since the op and the wound is healing very slowly now (much slower than it was before), which is very frustrating since I have always liked to stay active and exercise.

The whole thing is annoying but my advice would be to just get it done, it will be much better in the long run. It affected my life for almost a year so I am happy to go through this inconvenience to be cyst-free!

momnurse said on 28 February 2013

As a mother of a young adult son with pilonidal disease and as a wound nurse, I have been frustrated at the backward and forward progress of this wound that my son has. We have not finished the battle yet, however!

He has been trying to heal after excisional surgery in June 2012 and we have had many ups and downs. This wounds has made it impossible for him to stay in college due to the frequency of dressing changes that have been required.

I do know that arming yourself with good nutrition, fluids and vitamins is paramount to support the healing process. When a wound is stalled it is important to determine under lying factors that are contributing to this problem. A wound must always be addressed as a systemic problem as well as a local one. To all who have had problems with wound healing I recommend that your physician check hemaglobin, b-12, vit D, white count, thyroid, sed rate, albumin and pre albumin and an A-1c. These are lab tests that can help identify hidden contributing factors that are preventing wound healing.

For wounds that require packing, regular packing gauze may be alright to start with but if the wound does not show improvement with this regimen, your physician should be willing to try a different type of dressing such as an alginate rope with sliver or a foam strip with sliver. if the wound area sustains pressure from sitting, it is very important that the chosen dressing does not create a hard mass that further increases pressure and can ultimately increase the size of the wound. Pressure equals decreased perfusion and decreased oxygen and nutrients to the wound.

Even though I am a wound nurse, I have not been given any credibility in my requests for different types of wound management with regular surgeons or the primary physiocian. My son is now going to a wound clinic where I usually refer my patients. They are willing to try different dressings to see if that will help provide a more supportive healing environment.

ollybob2012 said on 11 February 2013

Starting to feel pretty down about this now as my surgeon has removed mine in four operations. I had 16 pits plus another 5 that reoccured. Because of this i have lost my dream job as a Producer for film and commercials and endured a lot of pain. My surgeon recons its the biggest he’s seen or heard of and that is down to not visiting the doctor for 6 years of feeling pain in that area. Im no martyr as stuff like this is so remidial yet so life changing, you need to see a doctor as soon as possible. Now is better than later trust me.

Leonna9 said on 18 December 2012

Hi,

I have previoulsy visited this website to ask about people healing time, I have now been for my 8 week check up and have discoverd I will definatly be needing a second operation as I have 4 or 5 Pits in the area wich need removing. Ive been told its only a matter of time before this comes and back and it WILL come back bigger and better. My question is has anyone else had to have this done? I am slightly confused between this and the bascoms procedure are they the same thing?

Leonna

adambw said on 11 December 2012

After reading all of the bad reports on here, I would like to put a bit of a happier time on here. I had my OP on the 26/10/2012 and just had my follow up appointment today and said all is well just got back in 3 months when after it all has healed to have a chat and that and then discharge me. I had it for 4 years before the right doctor sent me for a consultation. Best thing I have ever done it might be a pain in the backside getting my packing and dressing changed everyday but it will be worth it in the long run! 6 and half weeks down the line nearly all healed up now. If you have this do not wait for years like me, get to see a surgeon and get it done! By the way the op I had was wide excision was 6cm deep , 11cm in length and 2cm wide.

R123 said on 11 December 2012

Im 18 years old and I’ve recently had my second lay open and removal of a PS, after my first Op in July I was off work for a month and had to see a nurse every day for around 2 months, i eventually stopped seeing a nurse, i went back to work and then after about a week it returned, i had second Op in November, I am still having my wound dressed every day and yesterday they told me I now have another infection and this could mean a 3rd Op.

PS sucks

Leonna9 said on 30 November 2012

I am a healthy 21yr Old, and have just been diagnosed with PS after emergancy surgery 6 weeks ago,After coming round from thetre the surgeon told me that If I can take the pain of that then I could breeze through childbirth!.

Unlike most people on here ive never had any symptoms before, this litrally happand overnight for me and I can truely say ive never experianced anything like it I was on a morphine drip for 2 days leading up to surgery.

Im basically asking about people’s healing time I am about 8 weeks post op and have only just stopped having my wound packed everyday!!!, I visit my GP once a week and even he is atonished at the lack of healing procsess here, I am due to return back to see my surgeon in a weeks time to disguss weather they will remove the pits in the hope of stopping this returning as the biopsy wich was taken in theatre had neer or no trace of hair at all. They have told me the chances of this returning are high.

I returned back to work in an office after only 2 weeks with the aid of a special cushion.But I am now experiancing pain in my groin area, A pain i recongise all too well!! Has anyone else had a sinus in another area?.

Thankx

James1730 said on 01 October 2012

Can anyone help me please

I’ve had a very bad history with Pilonidal Sinus since the age of 16(now 38) and I have been receiving laser treatment to remove the hair.I had to go into hospital a few weeks ago and had a Sinus operated on and I need to go back again on Oct 9th to have it treated by a specialist.

The operation on Oct 9th will be my 27th and I was told they were going to try something different but I spoke to the hospital earlier and they confirmed the procedure is excision of pilonidal sinus + lay open.

Does anybody know if this is the standard open and pack for a few weeks?

I really do not want this type of operation as it really does not work for me so any help would be greatly appreciated

Rohit K said on 01 October 2012

Hi,

If you can help!!!

My sinus appeared in Oct-Nov 2011 for the first time and I saw there to be mild pain with some pus coming out. I thought it to be minor injury which could go with some antiseptics. I was wrong though and, I went to Doctor 6 months later. He said you haev Pilonidal Sinus and you can go for surgery. I didnt trust him as surgeon usally recommend to go for surgery (I dont know how much fun they have in doing them). I just have undergone Piles Suegry some 2 months back and docotrs advised some antiboitics for after Piles Surgery.
To my surprise, this antiboitics also cured Sinus.. I was so happy.. but my happiness didnot last long..

It started appearing again as I stopped those Antinoitics.I visited doctor again. he gave me ‘NeoSporin’ to apply and also press the Sinus each day so that it would drain-off the pus.

Now, I require your help!!

There is small sinus just as midline starts in the buttocks. It comes … Drains off… then comes…

What shall I do? Doctor says have a surgery, but i dont want to have it as I have lost some weight due to my piles surgery and doctor says avoid antiboitics as it would lower my immunity (I was happy using them). Please help. How can it be cured without surgery??

Waiting for your valuable comments..

Thanks,
Rohit

gerryevo said on 30 September 2012

I would say to anyone who has any of these terrible things or even thinks they have it,go straight to a&e as i did with two episodes of them,took me in both times the same day did op next day,and both times left it open and packed them.Do not waste time go straight to a&e…

Lorriejsparkles said on 02 September 2012

Hi, I’m a 17 year old girl and this happened to me so it could happen to anyone. I probably had my first lump about 4 or 5 months ago. I basically couldn’t move so I was going to make a doctors appointment but then it drained itself so I didn’t bother and thought that was that. Then it came back a few days later and it was awful. I made a doctors appointment straight away (A Friday) and they gave me antibiotics and made another appointment for me on the monday. It turned out to be so unbareable that I woke up screaming in the middle of the Saturday night and had to go to A&E the following morning. I was there from 10 in the morning until 6:30 in the evening. They did a minor op kind of thing while I was still awake and sent me on my way. So I thought – right hopefully that’ll be it then – No. And they don’t get less painful either. They hurt. I went to the doctors appointment and I was still fine but they made me an appointment to see a surgeon. He poked it and aggitated it but made an appointment with me for 2 months later so I could think about if I wanted the oporation so I just had to deal with it. If I couldn’t move then I couldn’t move. If you’re experiencing it try to stay in bad and move the minimal amount. I had my oporation last Tuesday (21st) and it’s been fine since but there’s a 10% chance of it not healing when it’s stitched up and a 20% it won’t heal when it’s packed because it has a higher chance of being infected. If you have it, I recomend you make an appontment to see a doctor immediately, whether it goes away or not. Hope this helps. 🙂

angelio said on 12 August 2012

I had my first drainage in november 2008, it happened within 5 days of getting that first ‘pain’ and by the 5th day I was in agony, couldnt walk, move etc.. it was drained and packed daily! I was about 6 months symptom free when it flared up again, but nothing to the extent that it had the first time! it would appear every 2-3 months and go down on its own within a matter of days, and again the pain was nothing compared to what it was the first time, infact it was more uncomfortable than painful. I find it appears when im stressed or studying (sitting for long periods). anyway i was on the waiting list for 2 years to have it removed (first op was only drainage) had it removed 2 weeks ago and it was stitched this time so hopefully it will cause me no more problems. they say its not genetic but my aunt, mother and sister all had it! my aunt and mum never had recurring ones but my poor sister has suffered awful bad with them, her’s was much worse then mine, she had 3 the first time it appeared and her’s broke the skin, while mine was under the skin. I just wanted to comment because everyone seems to have ‘horrendous’ stories about the pain etc.. but to be honest my experience with them has been nothing like it! yes it’s uncomfortable, and the packing the first time round was a nuisance but not painful and the operation themselves were painless when compared to the pain of having it! I dont think people should despair, they are alot more common than people think and are manageable with antibiotics or an operation. I know this is only my opinion but some of my friends who have had it too have said the same, it is manageable and doesnt impede daily living like some of the comments below suggests! I think people comment when they have really bad experiences so I wanted to get a ‘good’ experience out there! I do think more people have rather pleasant experience than bad ones, but those are the ones that never comment! so I hope this helps people, dont fret, its gonna be ok!

Sore Bum said on 24 July 2012

Do these things ever go away?!

I am a 28 year old female currently suffering the first attack of a pilonidal cyst. I think i may have had a few minor cases before, where it felt like a spot or a small bruise that would either pop like a spot or just go down after a few days. This this is excruciating. I’m on the 4th day of it now and its getting worse. Also I’ve had a fever, headache, shakes and sickness to go with it since a few days before the cyst came up.
I saw my doctor yesterday who prescribed antibiotics and painkillers and said it was not at a point where it could be lanced yet & to go back in 3 days if no change.
I actually think its getting worse. Now it is agony to sit, stand, walk or even lie on my front! Dr suggested sitting in a hot bath and I had to point out that sitting anywhere was not an option.
I have been crying and screaming in pain – this is actually giving childbirth a run for its money, at least labour only lasted 1 day!
What started off as a cyst to the left of the midline about 1 inch across, has now nearly doubled in size and another lump has now come up further down to the right of the midline but they seem to be connected. It hurts to even move and sitting on the toilet is very painful, then I am too tense to even go!
My dr advised that lancing is only a temporary measure and that more antibiotics may be required to clear the infection, and that surgery is an option but only as a last resort. But from what i’ve read on here, surgery doesn’t even seem to work most of the time as they still come back and it causes more problems than it solves? I do not want to have to live like this for the rest of my life. I am a single mum to a 3 year old daughter & things are difficult enough without having this to deal with as well. I have to look after her, and at the moment she is frightened by seeing her mum in this state.
ANy tips or positive success stories would be most welcome!

jess6106 said on 18 July 2012

Hi i’m 20 years old and i have just been diagnosed with PS, i’m soon having the operation. I work in an office and thus my jobs requires me to sit for long hours. Cn anyone let me know how long it took you after the op to sit for 8 – 10 hrs str8?

Thanks alot
Jess

Llinosjones said on 12 July 2012

I have been suffering from a reocurring pilonidal sinus for 8 years. I am a 24 yr old female and my first incision and drainage was just before my 16th birthday. It was packed every day for about 4 weeks. After that it kept coming back in the same place but burst each time after about 2 weeks on strong antibiotics. So i know the routine well. I had another 2 operations on it and it still came back.

I went for an MRI scan and it showed that the cavity has a number of tracts going into different directions. One of which goes right through my rectum muscles and through the gland (they call this tunnel a fistula) and its very painful.

It did ease off and I had no problems for 16months but it has just come back again. It seems to me that it always comes back when i have something im looking forward to or if i am under any stress. Obviously i eat healthily and excercise regularly.

So to anyone suffering from this horrible condition. I feel your pain! Hope someone someday can sort it out once and for all!!

Deinonychus said on 09 July 2012

@KelGlazebrook

I had a similar experiance, it was back in 2010, so can’t comment as up-to-date as you are, but I had surgery and IV anti-biotics to drain and remove the sinus, following that it took from the end of June until about two weeks before Christmas until it healed, I had been seen in several different area’s due to being at university. But I know it doesn’t see very good, never felt good in my self, had 5 different oral antibiotics, two of which needed anti-fungal treatment due to how strong they were… It isn’t nice!

There were a few months where it wasn’t healing, and they sent me to the hospital to investigate why it wasn’t healing, I wasn’t very impressed with it though, as they took one look (if that) and said yeah just carry on packing it – Not really very helpful for me, they didn’t give any time frame or anything! When I had surgery I was told it was a 3 week recovery… But six months it took. I hope you have a better experiance with the hosptial investigations!

KelGlazebrook said on 03 July 2012

Dear readers help!
I had a pilonidal sinus extraction done on the 19th April 2012, it was only a small op with a diameter of about a 50p piece and an inch in depth. I had a closed incision with no drain. I had the stiches taken out on the 3rd may because they were constantly being kept wet by a clearish liquid leaking from the wound. I was discharged with an open wound and have since had to have it packed everyday.
I am now on week 13 with an open wound of 2cms in depth which shows no signs of healing. I have now been referred back to the surgical team so they can explore as to why this thing isn’t healing. I am currently on my 6th lot of antibiotics due to infections in the wound and have felt unwell in myself since day one. I am now facing the possibility of having to cancel a holiday that has been booked for months because of these complications. My question is this has anyone else had any sort of complications like this? I can’t be the only one with these sorts of delays in healing. Please Help!Thank you

Dazzyrascal said on 13 June 2012

I have recently had surgery to remove three sinus’ that I have tried to ignore for several years despite the discomfort. I like most people read many alarming reports and comments online referring to the exteme pain post op and feel I should re-dress the balance a little. I had surgery only 5 days ago, and have been left with a large open wound, however the pain is nothing like I was anticipating. I left theatre having been given a local anesthetic and felt no pain at all until this wore off after about three days. I have the wound packed every morning, which is uncomfortable rather than painful. I am taking only Paracetamol at night to aid sleeping, other than that the pain is totally bearable, and I am planning to return to work after one week.
The purpose of my post is really to help anyone who may be about to have Pilonidal Sinus surgery realise that for some people the operation goes well and recovery is not too bad. Message boards are a bit like customers, people who have a bad experience tell everyone, whilst those who have no problems tell no-one. Good luck if you are having the op, go for it with a positive outlook and you’ll be fine.

tigger85 said on 10 May 2012

I have had this for the last 5 years,admittingly mine has not been as bad as some of these stories.
I started to nitice a bit of pain and as i had to go to the docs anyway i mentioned it and on the thurs they gave me anti biotics,by monday i couldnt walk, sit, laydown or anything. i got an appointment at the docs at 5pm, by 10pm i was in hospital having an emergancy op to drain the ps. its was left open and packed everyday for 4 weeks which wasnt nice as im also allergic to some plasters so had to keep changing what they used. that was 5 years ago but recently i have had aonther one further down, again i went to docs and got anti boitics,luckily this time it burst ,had it checked at walk in centre and they were happy that everything had come out. still need a week off work to make sure it had healed, im now left with 2 different scars the newest one is still a lump but hoping it doesnt turn into anything more.
As well as all the pain, tablets and ops its hard to keep a job while needing so much time off and ssp is rubbish theres no way anyone can live off that money

clareloug said on 08 May 2012

I’m a 28 year old female and have been having problems with a pilonidal sinus for the past 5 years. To date I have had 3 operations and numerous courses of anti-biotics. The first 2 operations were an incision and drainage and were packed daily by the nurse through my recovery. These took around 3 weeks to recover from. The 3rd was more invasive, cutting out the affected area, and was stapled closed. This took about a month to recover from. I have been told that it is not genetic but my brother and Dad have both had operations for the same condition (Dad had 1 and brother is on his 4th). I like to be active but have been very careful to not irritate my scar, so choose my exercises carefully (e.g. no sit ups or cycling). However, I am currently off work as the area has flared up again. I was given anti-biotics last week which haven’t touched it so I went back to the doctors today and they have doubled my dose. Interestingly, they said they can’t operate on the sinus until it reaches a head, which I was quite pleased about as the thought of another operation is far from appealing. I am not convinced the antibiotics are going to clear it up and I do get the feeling I am just biding time until another operation, but I am trying to stay positive!

rayanne2012 said on 31 March 2012

I had my first Excision of a Pilonidal Sinus in 2009. I had left the problem for around 3 years so those of you who understand, the infection was incredibly deep. 6cm length and 11cm depth…. 6months healing time with the district nurse in every morning=AGONY BEYOND BELIEF. Personally, the feeling of having to lay on your front for such a long time experiencing this long healing imprisonment is traumatic. your whole life stops especially if your young. I had some itching and sensitivity when in the bath and sitting down so went back to Hommerton Hosptial and had a scan and it was postive for a re-accurance!!!! >Heartbroken… to have to stop work just to deal with this again as the infection has inflammed and the Pilonidal Sinus is back. Much to my disapproval im due another excision on the 18th April…..
Anyone whos not sure of the Lower Buttock area… Please go to your doctors asap. Only people who have been through this really understand.

Jf93 said on 18 March 2012

Hi i have read a few different comments and found that a few people have used organic castor oil to help fix a pilonidal sinus so i researched it a bit and it does sound like it would do the trick as i would much rather it was healed through using the oil and dressings than getting surgery as anesthesia doesn’t work for me. so i was just wondering if anyone has tried this and if they could give me some advice? Thanks

morganF said on 15 February 2012

Im now going in for my 6th and 7th operation for my pilonidal problems ive had it operated on 5 times in 5 years and im due in for another 2 this year 🙁 ive been off work for 4 months now and after the ops expect to be off at least till november sick pay is bad lol, but hopefully this year will be the last that i have to put up with it, so my advice is get to ur gp straight away, and dont let them pawn u off with antibiotics because it will come back and recovery time is slow and painfull, in most cases, anyways anyway away for more tablets now 🙂

scott_h said on 15 January 2012

I had Pilonidal cysts, an abscess followed by a sinus… All I can say is that if you have symptoms, visit you GP/A&E as soon as possible. I was a fool and waited a week and the only reason I went was because I could not walk, sit, in fact I couldn’t move. It almost cost my my life leaving it until the infection was so far spread. I had 2 operations which were horrible. I was on Morphine for weeks and spent around 6 weeks in Hospital because I had left it so long. I had so many antibiotics in my system I was vomiting a lot and I could certainly tell that I was lucky to have not died. For 5 months I was having the wound packed which was so painful. Don’t get to that point, get it sorted quick! Don’t put yourself through something that essentially can be relatively easy to treat, even though you may have problems in later life!

Lynda2086 said on 12 January 2012

My name is Lynda and I was 21 when I had my first incision and drainage on a sinus on my buttocks. The operation was done uner anaesthetic and I was off work for 7 weeks in recovery as there were complications with infections.
In June 2011, I was feeling really ill and the scar was itchy. I called NHS 24 and when I was examined at the hosptial in A&E, I was admitted for another operation to incise and drain another sinus, in exactly the same place. This was done in Glasgow Royal Infirmary. My mam took me back home to the highlands where I was sue to see the district nurse to change my dressing. When she took a look at it, she said she wasn’t hapy with it, and so I was admitted to a local hospital where the sinus was re-lanced.
The next morning, the nurse came to the house to do the dressing, and still wasn’t happy and so I was readmitted to Raigmore hospital in Inverness where I underwent a thirs operation. I was off work for 6 weeks, again due to infection which complicated and extended the healing process.
This week, I was in the bath and the scar area was really sensitive and itchy so I went to the doctor to have it checked out and sure enough, there is another sinus. The doctor prescribed me flucloxacillin which has given me thrush but has not helped the itching and sensitivity. I am going back to the doctor tomorrow as an emergency appointment, having spoken to her today, and she suspects I will need to be admitted to surgery for the 5th procedure in 5 years.
The advice I would give to anyone who has an itch, or sensitivity in this area, is to go to a doctor straight away. Better to be safe than sorry. I’m in absolute agony and am dreading going through all of this yet again.

miaelwilliams said on 09 January 2012

Around November 2010 I felt a lump at the bottom of my spine, causing me much pain to sit down.
I took quite a while off work and went to A&E to see if they could help. They told me it was a broken Coxyx.
I went back to work after a lot of pain killers, only to find it too hard to sit at my desk all day.
I went to my GP and was told i had an abscess there. I was given antibiotics which caused the abscess to burst and leave blood and puss.
This was fine although there was still a small lump there. Until August 2011 I had this flare up another 3 times until i was sent to the hosptial to have it removed.
I had it done under general anesthetic and was in much pain after. I had been left wth an open wound which had to be packed daily – not good when back to work.
I kept getting this packed for 13 weeks! During this time i was told that they had found a “cavity” a part of the wound they had not been packing. I also had to have more antibiotics because of this.
After the 13 weeks i had an appt with the surgeon and i was hoping he would then dismiss me. No such luck. he told me i needed another operation to remove the root?? and the first one was to remove the infection.
has anyone else had to have 2 operations as i am feeling like something has gone wrong and they are trying to cover it up.
my 2nd operation is on the 18th of this month and i am dreading the pain after last time 🙁

kelly1992xx said on 16 December 2011

I suffered from a pilonidal sinus. And feel your pain is the worse thing I have ever been through as it was 2 years ago and I was only 17 years old, now the scar has swelled up its not a round scar its more like a downward slit. I went to docs and put me on antibiotics I just wondered if anyone else had this happen and if it means its definatly coming back as am dreading the op again

pilondial sinus said on 24 November 2011

i was diagnosed with pilonodil sinus 3 months ago. I had 4 weeks antibiotic course and it went away { there was a little lump left there though}. after about 4 months it started flaring up again. i went to doctors they gave me antibiotic again for one week and said if it doesnt go than we will refer u to the speacialist for surgery. i was sooo scared of surgery after reading so many people’s post operative pain. i started searching for herbal remedies. i used castor oil and it was like a miracle. no pain at all and the swelling is lot less. its only third day i m using it so far no drainiage looks like wont be any coz i m having herbal tea to detoxify body.probably thats y . not sure.
i wanna shout out loud to tell the world how beneficial castor oil is.

jessxca said on 24 November 2011

My boyfriend has suffered so bad with this for the past two and a half years. First operation back in 2009 in August, very strange for him as he a very active person and loves to keep fit. The aftercare from the operation was hurrendous, they stitched the wound and then realised a week or month later it shouldnt of been so they removed it and started to pack the wound. 6 months down the line still packing and had a check up. Nurse found they had left stitches in his wound and tissue had starting to form which why his wound wasnt healing. very damaging for him and extremelly painful. he had to have another op to sort it out, again months after that still wasnt healed, doctor pulled it apart (with no anesthetic) and said another op was needed, last op was like november 2010. still ongoing, doctors everyday for a year and last week was told at docs he had a hospital check up on the wednesday which was not told by a letter? doctor examined him again and pulled apart his skin AGAIN!!.. we dont know what to do, him, me, or his family. We feel very let down by the NHS, aftercare and neglegance. we do not know where to go from here? go private but how can we afford? We have been go solicitors but its very hard to sue for what has happened? any thoughts on where to go next? as he is extremly upset and feels like he cant do anything which he cant. anyone can help please?

kelsoxo said on 15 November 2011

I first noticed some swelling on a Thursday and thought it was just a bad ingrown hair (having never heard of PS before i wasn’t that bothered) over the weekend it got quite large and even though it takes quite a lot for me to go to the doctors i realised this was quite serious and was down there first thing monday morning.
I was given a 7-day course of anti-biotics that the GP gave me but looking back now i dont think anti-biotics could ever have worked. I am female, at the time i was 25 and my sinus was not at all like the one pictured above. Mine was much lower, almost next to my anus and it was deep under the skin and didn’t weep or leak at all as the skin was unbroken.
I went to A&E on day 4 of my course of anti-biotics as it was becoming impossible for me to get out of bed without a handful of ibuprofen and paracetamol and it looked highly unlikely i would be cured in the next 3 days!
I waited 3.5 hrs to be seen which is pretty standard in a busy hospital (Belfast City) and when i was the doctor told me it was one of the largest he had ever seen! I was taken to a ward immediately and within the next 3 hours was asleep under a general to have it drained.
I cried the first 3 times i had my wound packed. It was painful, but you get used to it and it gets better. This was the first big health scare that i’ve had and it was stressful for me. If my dressing came off it would really freak me out having to put another one on. It took 4 weeks of daily packings and 2 more weeks of seeing the nurses every second day before my wound was ‘healed’. I now have an impressive circular scar about the size of a 20p coin. This was May 2010 and i’ve not had any problems since so hopefully i’ll be one of the lucky ones, although there does seem to be lots of storie son here where people have had trouble with them coming back. Very grateful to all the doctors and nurses who helped me at the time!

frances duffy 94 said on 04 November 2011

my name is frances, and im 17. I have had my first operation which was the incision and drainage, with daily packing in august 2011, i must admit the pain is just unbearable!,then in october i had the excision of the absess, and it was stitched which left me with just daily-painfree dresings. Then 2days ago, i went back to have my stitches removed expecting good news that it had healed yet, he was the opposite of happy, with my progress, as the wound has become infected…which now am on 4 antibiotics and have to go to the consultant again on the 28th of november, People who dont have pilonidal sinus, genuinely have no idea of the pain , both men and women. Im 17 and iv my exams this year which is importent, yet i dont get a chance as im in hospital for check ups, and now the infections back. The annoying thing though is one little ingrown hair is the dominant cause!! Anyone who has any advice etc, please comment and to who has P.S( Pilonidal Sinus) the best of luck!! xox

Rabspat said on 04 October 2011

I suffered from a sinus for a very long time, my GP started me on antibiotics and for the practice Nurse to pack it. None of that seemed to work and went on for a long time. My GP then refered me to the local hospital and i got told that it be best to be seen at Queen Victoria Hospital East Grinstead by a person who knew about them. So after waiting for the appointment at QVH, finally got one, i was told best option was a Skin Graft. Had the surgry for a year now, been on and off antibiotics and check ups with the GP and QVH to make sure we are on course. Doctor was worried that the graft did’nt work and that i might need a second OP. I am hoping that i won’t need the second OP as i really would like to get past this and move on, been going on since i was 20. I am now 29.

dw82 said on 14 August 2011

I have suffered ps for last 4 yrs ive had 2 operations so far.after the 2nd op it seemed to work it healed and pain went but after 12months the hole reopened after my nurse packed it for awhile it healed but then over 6 months ago it opened again the nurse cant heal it. it is totally open and the nurse is able to get a whole pack of sorbsan in. it is coursing me alot of pain and affecting my life as im resrickted in what u can do with the pain I spend alot of days crying. im going back to hospital tomoz after being re refered by my doc I just dont know what the can do but hoping something will. can anyone suggest what has worked please I need help

HSrox said on 16 July 2011

i’m not going to lie to anyone, these things are annoying little bliters. i’ve been suffering with the sinus for about 2 years now, within a year of finding the sinus, i was placed in surgery to excise the infected area under general anesthetic. but as you could probably tell, the surgeon i had botched the operation and the wound was put into a cycle of opening, infection, closure then back to opening and infection again then it tracked and opened a large wound having to go through that for another year depressed me heavily as i felt it would never end. the infection was resistant to augmentin, which i was told in science is a strong antibiotic i started worrying about it being MRSA but i was reassured. then tuesday just gone, i underwent surgery again with a plastic surgeon and he injected dye into the wound and discovered a HUGE underlying infection under the scar tissue from the last post op wound.
he had to cut a long and VERY deep incision to remove the infected tissue, i was given numerous antibiotics during surgery and due to the size of the wound and the pain it would have caused i had to stay overnight in case i needed morphine, but i didn’t.
my whole summer holiday has been ruined, and i’ll keep having to have operations every 6 or so months now. but i think it’s worth it to sit down without pain again. i feel sorry for anyone going through this, it isn’t nice and could on the rare occasion get a hell of a lot worse.
so good luck to anyone who is about to undergo surgery, and godspeed.

Random1 said on 09 December 2010

Hello,
I have had a pilonidal sinus for over 2 years now.
Since then, i have had:

– Incision & Drainage (followed by prolonged packing in the open wound) in 2009

– Closed surgery (stitched up the mid-line) in summer 2010

After both operations, the area refused to heal in part and drained daily, so I’ve been using saline solution to clean the wound and lightly dress/pack with kalkostat and guaze swabs (fixed on with a small amount of surgical tape). This has without a doubt been the best way to reduce infection for me. I shower twice a day and do the above twice daily and since doing this, I have suffered no recurrent infections (previous to this technique I reguarly suffered from infections caused by using dressing which are too restricting for air supply and not using saline solution for cleansing). Normal water just won’t do and do not bathe, no matter what anyone says, there will be germs/bacteria in the water which can cause re-infection.

Now, for wound healing. After two years of the above and recently been told I need a third operation, I paid private and the specialist consultant disagreed with my NHS consultant. Instead of an op and because I have only two small areas which refuse to heal, I have been prescribed ‘FUCIBET’ cream, which is steriod ointment for 4 weeks, twice daily. I am half way through and I can say that this stuff works miracles! Why no one has suggested this before to me, I do not know!

I cleanse with saline, lightly rub on fucibet (making sure hands are clean before and after!!!) and covering with guaze swab. My wound is better than it has ever looked!
I am very happy and I think that using a cream rather than going through yet another operation is an amazing result!
I will continue for 2 week more with the cream but I am amazed! I wanted to share this with fellow sufferers! Good Luck! xxx

younglady said on 28 September 2010

After suffering for years with PS and having the most painful attacks, i was also told to take antibiotics and rest. it wasnt until two years ago i saw a locum at my local surgery who told me my blood was being poisoned and it needed operating, by this time even when i didnt have an attack black lumps were beginning to fall out the hole so when i was seen at the local hospital they decided it needed removing asap. Due to the size of the incision needed i was offered a Limberg Flap plastic surgery operation. I was sent home with details and asked to consider this option or i could always have the normal wide excursion. After alot of research i choose the Limberg Flap and i can honestly say it was the best decsion of my life. The operation lasted a few hours (i also needed an epidural) and when i came round i can honestly say i didnt have any of the pain i was warned about, the surgery was a success and was discharged from hospital after 4 days. the recovery at home was the worse as i was unable to sit or lay for nearly 5 weeks until after i had my stitches out. so i would recommend to anyone, ask your surgeon if they can do the limberg flap – it changed my life!!

User203493 said on 20 September 2010

I’ve just came back from hospital after having the operation, its the best thing ive ever done. I had the pilonidal sinus 4 times and they kept growing faster every time and getting harder to sit down, it didnt help we were sttting in A&E for 9 hours! The pain after it was unbelievable, i couldnt believe a half an hour operation would give me so much relief. Its still sore to sit down but not half as bad as it was on Saturday. I’m going to the Nurse in a wee while to get it stuffed and dressed again… I wont say thats painless as it is very sore for me! But i would rather have that pain than the sleepless nights, pain when sitting down etc. Dont put up with the pain, get it seen to ASAP, you will be surprised at how something so simple can help sooo much!!

gadji drummer said on 01 September 2010

hi,i was given the news i had a pilonidal sinus five years ago,since then i have had the operation to cut it out twice but behold its back again.iam on more antibiotics to reduce the swelling and waiting to see the surgeon,the first time they cut it out and stitched me up .one year later it was back,the next time they left a large hole which was packed every day ,it wasnt two bad,my father had the same condition in the seventies but back then they sprayed peroxide then packed it,this was unimaginably painfull but it never came back.if u are unlucky enough to get this condition seek help straight away,there is no point in proloning your own pain

davidlp said on 31 July 2010

I am aware someone has suggested going to BUPA so that the wound created during the operation can be stitched up. You don’t have to do this, as some NHS consultants do stitch up the wound. I had the operation recently and was stitched, but unfortunately the stitched wound would not heal, so after the stitches were removed the wound was open. I am now having it packed, and it is not as bad as some people made me think it would be. It is actually more comfortable now that I don’t have tight stitches.

The nurses have told me that it isn’t uncommon for the stitches to not have an effect, or for the closed wound to burst open. If it does heal closed, it is apparently better for you though.

I would recommend to anyone thinking they have this to visit their GP. My GP immediately sent me to a consultant, who told me that surgery is the only proven way to treat this condition. Don’t wait two years before seeing a GP like I did.

Welshlady said on 05 July 2010

I have suffered from this condition for the past 10 yrs, since I was 50. I have had 2 ops, both large and small, but it still recurs. I have just had 2 sinus infections one after the other, before the first had even healed, this has never happened before. I usually get a few months in between at least, so this is worrying. Antibiotics are not the solution, as it just drags on for 6 weeks, and with the operation it takes 6 weeks of daily dressings to heal, as I still work full time I am very worried about the effect this will have on my job. As I find it difficult to work when the infection is there. I wish there were some sort of treatment that would help to stop them recurring. I am active, healthy, do not sit down all day, do not have a prblem with hair(both ops they never found a single hair)! The pain, discomfort, swollen lymph glands all over my body, plus the terrible side effects from too amny antibiotics are awful. I just returned from Greece, where I almost ended up having emergency surgery, but managed to get away with having it lanced instead, so I could fly home. I am awiting another appointment with the surgeon, hoping that he will come up with another option…I live in hope…but my advice to everyone else…insist on seeing a surgeon, and don’t chance blood poisoning like I did, because I was too afraid to go to ER at the weekend or middle of the night, this condition is serious. and needs to be taken seriously, by sufferers and GP’s

DawnyDawn said on 04 June 2010

These things don’t happen to girls as often as boys, and I never considered myself to have the hairiest of bottoms… but never mind, having had the operation to lay open a pilonidal sinus right at the top of my cheeks, I can honestly say I’m pleased it’s on it’s way to healing. And I’m glad that I was able to have the operation right away rather than be messed around with lots of antibiotics etc. The District Nurses are taking fabulous care of me and packing it daily, and it’s not as horrifcally painful as I imagined it would be.I am so bored and wish I could go back to work, though…and i really really hope it doesn’t come back!

User210608 said on 09 May 2010

User210608 said on 01 May 2009…

Follow up from my comment on above date:

Exactly one year on, having had the odd pain during the year, the lump, pain & swelling is back. Not as painful as last year but I think it is developing quicker. Going to see doctor (the helpful one from last year!) tomorrow so try and stop it from getting worse. He suggested surgery if it returned- removing the skin on the area & allowing it to heal on it’s own so i am reading up on that. Don’t have/can’t afford BUPA or plastic surgery unfortunately.

Last year the doctor at the hospital refused to check below my waist- I made a complaint because I was sick of hearing in the news of people dying when doctors refused ot treat them- I didn’t want that doctor doing that to anyone after she ignored my symptoms. She denied the way she treated me but as soon as I told the hospital I was taking the case further she agreed that she hadn’t treated me right and agreed to be more careful in future.

I know going to the doctor with something like this can be embarrassing but it is not worth leaving it- it will get worse, may get infected and can be very painful. Get it seen to as fast as possible.

Good luck and feel better to you all!

kjones72 said on 08 February 2010

I have been the doctors again this has been going on for 5 years and I am a female in her late 30s I have all the same symptoms redness pain smarting blood pus and I can not sit for to long I have to lay down on my side so I am not in pain, the doctors say I don’t need surgery I think I do, Its not going away and tablets do not work any advice please. I dont know how much more pain I can take I am worried about losing my job having so much time off.

jdf5233 said on 30 November 2009

I had suffered from pilonidal sinus for about 6 years. I would often go to my GP explaining my symptoms, but he was the type of GP to stay behind his desk and not touch any of his patients. After 6 years of being on antibiotics on and off, I finally went back and said if you don’t refer me I will report you to the GMC.
Thankfully he referred me straight to a general surgeon, who diagnosed straight away. He did say that he was shocked to see that I had this, as the condition is more common in men and in ‘hairier’ people. So I was put on waiting list for a operation to remove.
Unfortunately while waiting for the op, my sinus flared up again for over a week I couldn’t sit down without being in pain, i decided to have a bath to see if this could ease any pain. 2 seconds of being in the bath the water was a slightly disturbing reddy, yellowy colour – shocking and not nice. My partner took me straight to A&E, they then booked me in and scheduled me for emergency surgery the next morning to remove the infected area. I then spent the next 4 weeks going to the local GP surgery to have the wound packed every day. Thankfully I was then given my date for the full removal of the sinus operation.
Upon surgery of which they removed the whole area and then stiched backed together, I had to stay in hospital for 5 days with a drain attatched to me.
Slight pain upon coming home and was a build of fluid at one point but did just burst out at one point, which did affect the healing process.
Thankfully a year on I am now boil, pus and pain free. I would recommend anyone that has this to go for the full operation and asked to be stitched back together with the drain. Having had both I know which one is the easiest one to deal with!!

FredMallooga said on 19 November 2009

I was aware two weeks ago of a swelling around my Natal Cleft, I thought I had an abscess and booked an appointment at a nearby doctors, as I was away on holiday. I explained my condition and showed him the painful lump. I poked my buttock and said I had a fungal infection and refused to listen to what I said or failed to explain my swelling. He called it a fatty lump and when asked why it had grown from nothing to this in a few days only replied by saying that he hadn’t examined myself earlier and so, had no idea whether it had grown or not! Armed with a prescription for some Canesten left. The lump grew and became more painful. At the weekend I went to AE, I saw an out of hours GP there. I’d done some research prior and self-diagnosed myself as having a Pilonidal Sinus, which subsequently I found out that this condition runs in my family. The GP examined me and once again failed to listen to what I said, she just said it was nothing to worry about, called it a Bad Boy Boil and wrote me a prescription for some strong antibiotics. She said that Pilonidal Sinuses are not normally found there and are more anal…. The antibiotics worked well, since then I’ve seen my GP who has confirmed my condition and he has arranged for a consultation with a surgeon. I think I’ve got more than one sinus, I was aware of a dormant sinus and now since the abscess I now have a large hole due to the infected one draining. I’ve read these notes here and I’m now worried about the possibility of repeated surgery!

Helena330 said on 22 September 2009

I have had this for 3 years now; up till about a month ago, I thought I could cope but now after being on and off antibiotics all summer, the infection is still there, and I’m about to start on another course. My doctor tells me they wouldn’t really want to operate on me, but I’m sick of the stress of having the thing there, all the time.
However, looking on the bright side, what a priviledge to be one of the 26 in those 100,000 people! Or not…
my sympathies to everyone else going through this ordeal!

Pugsie said on 16 August 2009

I had a lump that wept for about 4 years, thought it was due to sweat as i did a lot of running but was in fact a pilonidal sinus and its "tunnel" had grown really deep into my bum – all very painful. Doctor said straight away that is was a sinus and as my mum is a nurse she told me about the "open" healing method which sounds awful. I had private healthcare with Bupa so went private and had a plastic surgeon that specialised in a "closed" procedure. Removed the sinus and using a flap technique sewed me up – was in 1 night and off work for 2 weeks but honsetly had no pain during the healing – discomfort and tight feeling but only have 2 inch scar that has completely faded (mine was considered a deep sinus where a lot flesh was removed) – would def reccommend a plastic sugeon as the result is excellent and recurrence is low with this procedure – no mess and heals well with dissolving stitches.

craigtrap said on 19 June 2009

In october 2006 i had a wide excision to have a sinus removed from my bum, it was so painful! everyday i had to go to the doctors to get the wound packed by a nurse! and around 4 months ago i had a burst of pus from the area, went straight to the doctors, my doctor told me that it wasnt a sinus again but it was because it hadnt healed properly, there was apparently a gap in which the healing had grown over and it had grown larger and evertually burst, that was painful, and the moment i have been dressing it myself and going back to see the nurse every week, the whole process of having the sinus has taken over 2 years now! If you get a sinus and have it removed make sure you keep it clean and getting it packed and dressed properly, i have now learned from my mistake i will not be ignoring it anymore! Big mistake to make! I feel sorry for anyone that gets one!

matt3865 said on 17 June 2009

at the back end of september 2006 i started gettin pain with this lump i had after taking a trip to the drs i was refered to my local hospital with a pilonidal sinus it was so painful i culd barley walk. the sergeon recommended i have a operation asap to relief the pain this involved cutting the whole thing out and they found at least another 3 with the area where the orginal pilonidal sinus was. it was painful but worth getting sorterd before it burst or got worse. i was off work for 2 months while the wound healed. it was a long and painful process. my advice is for anyone who thinks they may have 1 is to get it checked straight away and get it treated before it progresses and becomes really painfull. its been nearly three years now since my operation and i am afraid to say the pilonidal sinus is back as the comment above says its something that will not go away unless treated. and unless u listen to what the sergeon says about what to do when its healed it is seriously the best thing to do do not ignor it as i did the pain is not worth it!

Clairey_89 said on 23 May 2009

on 25th april 2009 a lump appeard at the top of my bottom. 2 days later i went to the doctor and was given a strong anti-biotics to clear up the infection. 3 days later after unbelievable pain and no sleep for 6 days .the abscess burst. i went to the nurse who tried to remove the rest of the puss. I Was Sent To My Local Hospital to See The Surgeon . He Lanced It To Make Sure No More Puss Was in There( Which Was Painful as i had No Pain Relief) They Packed The Wound And Sent Me On My Way. The Operation to Remove The Sinus was what i should have got but i was very lucky. Im Now on My 5th week of treatment . i Have To Go To The doctors Everyday to get my wound packed . It Is Extreamly Painful. This isnt a illness That Will Go Away . you Need Treatment . see your doctor asap.The pain is horrific !! And Fully Expect to be off work for some time. as they pain makes it too hard to sit down .

User210608 said on 01 May 2009

I called NHS hotline last week for advice on a painful lump at the top of my buttocks. The nurses were very sympathetic and helpful and they made me an appointment at the out-of-hours surgery at my local hospital but the doctor there refused to check me below my waist. The next day a doctor at my surgery gave me antibiotics but didn’t think it was a sinus. 3 days later, after immense pain & agony, the sinus grew and opened and another doctor at my surgery gave me the correct antibiotics and strong painkillers. Last night is the 1st night in a week that I got sleep. The sinus is finally draining and the pressure and pain is easing off. I am going back to the doctor today for a checkup but I already feel better.
If you think you have a sinus SEE YOUR DOCTOR. Don’t leave it too long. The pain and discomfort are not worth it.

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Pilonidal sinus

Complications of a pilonidal sinus

[Original article on NHS Choices website]

Several complications can occur as a result of surgery for a pilonidal sinus.

The pilonidal sinus can return

One review of several studies found that the pilonidal sinus returned in 7 out of 100 people who had surgery to remove it. Leaving the wound open after surgery, rather than closing it, reduced the risk of it returning by over one-third.

Infection at the wound site

Infections can occur at the site where the pilonidal sinus was removed. One review found that infection occurred in up to 13 out of 100 people. Whether the wound was left open or closed did not affect the rate of infection.

Contact your GP immediately if you notice any signs that your wound may have become infected. Signs of infection include:

pain
red, swollen skin
a high temperature of 38C (100.4F) or above
a feeling of heat at the site of the wound
fluid, pus or blood leaking from the site of the wound
an unpleasant smell coming from the site of the wound

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Published Date: 2011-09-11 18:07:51Z
Last Review Date: 2011-03-03 00:00:00Z
Next Review Date: 2013-03-03 00:00:00Z

Classification: Pilonidal sinus

Pilonidal sinus – NHS Choices

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Pilonidal sinus

Overview
Pilonidal-sinus Clinical trials

Introduction

Pilonidal sinuses commonly occur at the top of the buttocks

Who is affected?

Pilonidal sinuses are rare, affecting about 26 in 100,000 people each year.

Pilonidal sinuses affect at least twice as many men as women. The average age for a pilonidal sinus is 21 in men and 19 in women. They are less common in children and people over the age of 40.

A pilonidal sinus is a small hole or “tunnel” in the skin. It usually develops in the cleft of the buttocks where the buttocks separate.

More than one hole may develop, and often these are linked by tunnels under the skin.

Most people associate the word sinus with the nose, but sinuses can occur anywhere in the body. Sinus is simply a medical term for a channel or cavity.

See your GP as soon as possible if you think you have a pilonidal sinus. Without treatment, any pain and infection may get worse.

Your GP should be able to diagnose a pilonidal sinus after carrying out a visual examination of the affected area of skin. Further testing is not usually required.

Read more about the symptoms of pilonidal sinus.

Why do pilonidal sinuses happen?

The exact cause of a pilonidal sinus is unclear, although it is thought to be caused by loose hair piercing the skin. The term “pilonidal” is Latin for “nest of hairs”.

Certain things can increase your chances of developing a pilonidal sinus, such as being obese, having a large amount of body hair and having a job that involves a lot of sitting or driving.

Read more about the causes of pilonidal sinus.

How are pilonidal sinuses treated?

If you have a pilonidal sinus, it is important to keep the area clean and dry. It may also help to remove any hair near the sinus. These steps can reduce the risk of infection.

Showering at the end of the day to remove hairs fallen from your head or back into the cleft between your buttocks may also help.

If a pilonidal sinus becomes infected, it should be treated as soon as possible, as it is likely to get worse.

You may initially be treated with antibiotics, but you will also need to have the pus drained out of the abscess during a minor surgical procedure called incision and drainage.

If it keeps becoming infected, surgical removal of the sinus is usually recommended. Several techniques can be used to do this, including:

cutting out the sinus and leaving the wound open so it can heal, and packing it daily with a dressing
closing the wound with a flap of skin and stitches
scraping out the sinuses and filling them with a special glue

Read more about treating pilonidal sinus.

Page last reviewed: 20/11/2012

Next review due: 20/11/2014

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Comments

The 75 comments about ‘Pilonidal sinus’ posted are personal views. Any information they give has not been checked and may not be accurate.

momal35 said on 30 September 2014

RainbowHorror01 said on 17 September 2014

Tgbailey77 said on 16 September 2014

My advise would be to pre warn your employers that you may be off work for some time and until operated I’m afraid you don’t know how long.

Hswatkins said on 08 September 2014

Saralucy92 said on 16 April 2014

Millak said on 06 April 2014

meganmolly said on 20 February 2014

soundz said on 19 February 2014

poil said on 28 December 2013

Mkhan87 said on 23 December 2013

londoner80 said on 13 December 2013

Tomothy Terrific said on 12 December 2013

“Aftera storm there is always a chance for freshness and growth”

Tomothy Terrific said on 06 December 2013

I’ll keep you posted on everything 🙂

"laughter is my favourite drug"

Tomothy Terrific said on 03 December 2013

Thanks 🙂

“Even if you don’t feel like it, smile, it helps maker others feel better.”

jessie77 said on 06 November 2013

Now its flared up again, I wonder what the gp will say this time when I go back to see her.

Leonna9 said on 19 September 2013

In reply to Arctichelen_

Hope it gets better for you.

Arctichelen_ said on 16 September 2013

plumtuckered said on 13 September 2013

teapotcfj said on 25 June 2013

Leonna9 said on 20 June 2013

Lollibob said on 16 May 2013

berniethebolt said on 25 April 2013

woosie42 said on 23 April 2013

seanysinus said on 19 March 2013

User752510 said on 01 March 2013

momnurse said on 28 February 2013

ollybob2012 said on 11 February 2013

Leonna9 said on 18 December 2012

Hi,

Leonna

adambw said on 11 December 2012

R123 said on 11 December 2012

PS sucks

Leonna9 said on 30 November 2012

Thankx

James1730 said on 01 October 2012

Can anyone help me please

Does anybody know if this is the standard open and pack for a few weeks?

I really do not want this type of operation as it really does not work for me so any help would be greatly appreciated

Rohit K said on 01 October 2012

Hi,

If you can help!!!

It started appearing again as I stopped those Antinoitics.I visited doctor again. he gave me ‘NeoSporin’ to apply and also press the Sinus each day so that it would drain-off the pus.

Now, I require your help!!

There is small sinus just as midline starts in the buttocks. It comes … Drains off… then comes…

Waiting for your valuable comments..

Thanks,
Rohit

gerryevo said on 30 September 2012

Lorriejsparkles said on 02 September 2012

angelio said on 12 August 2012

Sore Bum said on 24 July 2012

Do these things ever go away?!

jess6106 said on 18 July 2012

Thanks alot
Jess

Llinosjones said on 12 July 2012

So to anyone suffering from this horrible condition. I feel your pain! Hope someone someday can sort it out once and for all!!

Deinonychus said on 09 July 2012

@KelGlazebrook

KelGlazebrook said on 03 July 2012

Dazzyrascal said on 13 June 2012

tigger85 said on 10 May 2012

clareloug said on 08 May 2012

rayanne2012 said on 31 March 2012

Jf93 said on 18 March 2012

morganF said on 15 February 2012

scott_h said on 15 January 2012

Lynda2086 said on 12 January 2012

miaelwilliams said on 09 January 2012

kelly1992xx said on 16 December 2011

pilondial sinus said on 24 November 2011

jessxca said on 24 November 2011

kelsoxo said on 15 November 2011

frances duffy 94 said on 04 November 2011

Rabspat said on 04 October 2011

dw82 said on 14 August 2011

HSrox said on 16 July 2011

Random1 said on 09 December 2010

Hello,
I have had a pilonidal sinus for over 2 years now.
Since then, i have had:

– Incision & Drainage (followed by prolonged packing in the open wound) in 2009

– Closed surgery (stitched up the mid-line) in summer 2010

younglady said on 28 September 2010

User203493 said on 20 September 2010

gadji drummer said on 01 September 2010

davidlp said on 31 July 2010

The nurses have told me that it isn’t uncommon for the stitches to not have an effect, or for the closed wound to burst open. If it does heal closed, it is apparently better for you though.

Welshlady said on 05 July 2010

DawnyDawn said on 04 June 2010

User210608 said on 09 May 2010

User210608 said on 01 May 2009…

Follow up from my comment on above date:

Good luck and feel better to you all!

kjones72 said on 08 February 2010

jdf5233 said on 30 November 2009

FredMallooga said on 19 November 2009

Helena330 said on 22 September 2009

Pugsie said on 16 August 2009

craigtrap said on 19 June 2009

matt3865 said on 17 June 2009

Clairey_89 said on 23 May 2009

User210608 said on 01 May 2009

Useful links

NHS Choices links

External links

Pilonidal sinus information (PDF, 80kb)

Keep skin healthy

Keep skin healthy in all weathers. Plus common skin conditions and treatments, including acne

NHS Choices Syndication

Representations

/conditions/articles/pilonidal-sinus/introduction

Pilonidal sinus

Introduction

[Original article on NHS Choices website]

A pilonidal sinus is a small hole or “tunnel” in the skin. It usually develops in the cleft of the buttocks where the buttocks separate.

More than one hole may develop, and often these are linked by tunnels under the skin.

Most people associate the word sinus with the nose, but sinuses can occur anywhere in the body. Sinus is simply a medical term for a channel or cavity.

See your GP as soon as possible if you think you have a pilonidal sinus. Without treatment, any pain and infection may get worse.

Your GP should be able to diagnose a pilonidal sinus after carrying out a visual examination of the affected area of skin. Further testing is not usually required.

Read more about the symptoms of pilonidal sinus.

Why do pilonidal sinuses happen?

The exact cause of a pilonidal sinus is unclear, although it is thought to be caused by loose hair piercing the skin. The term “pilonidal” is Latin for “nest of hairs”.

Certain things can increase your chances of developing a pilonidal sinus, such as being obese, having a large amount of body hair and having a job that involves a lot of sitting or driving.

Read more about the causes of pilonidal sinus.

How are pilonidal sinuses treated?

If you have a pilonidal sinus, it is important to keep the area clean and dry. It may also help to remove any hair near the sinus. These steps can reduce the risk of infection.

Showering at the end of the day to remove hairs fallen from your head or back into the cleft between your buttocks may also help.

If a pilonidal sinus becomes infected, it should be treated as soon as possible, as it is likely to get worse.

You may initially be treated with antibiotics, but you will also need to have the pus drained out of the abscess during a minor surgical procedure called incision and drainage.

If it keeps becoming infected, surgical removal of the sinus is usually recommended. Several techniques can be used to do this, including:

cutting out the sinus and leaving the wound open so it can heal, and packing it daily with a dressing
closing the wound with a flap of skin and stitches
scraping out the sinuses and filling them with a special glue

Read more about treating pilonidal sinus.

Useful Links

Published Date: 2013-08-06 10:16:30Z
Last Review Date: 2012-11-20 00:00:00Z
Next Review Date: 2014-11-20 00:00:00Z

Classification: Abscesses,Pilonidal sinus

NHS Choices Syndication

Representations

/conditions/articles/pilonidal-sinus/symptoms

Pilonidal sinus

Symptoms of a pilonidal sinus

[Original article on NHS Choices website]

A pilonidal sinus is a small hole or channel in the skin that most commonly occurs at the top of the cleft between your buttocks. It may not cause any noticeable symptoms unless it becomes infected.

However, not all pilonidal sinuses occur near the buttocks. They have also been recorded in the belly button or between fingers. In many cases, there is more than one channel.

If the sinus becomes infected, an abscess will usually develop. An abscess is a painful collection of pus that causes symptoms such as:

pain
redness of the skin
pus draining from the sinus (the pus usually smells unpleasant)
blood draining from the sinus
a high temperature of 38ºC (100.4ºF) or above, although this is uncommon

These symptoms may develop quickly, often over a few days.

The pain caused by a pilonidal sinus can be severe and is likely to get worse without treatment. This can make it difficult to sit or lie down comfortably, which may affect your sleep. The pain may also affect your ability to work and your daily activities.

You should see your GP as soon as possible if you suspect you have the condition. They can examine you and discuss possible treatments.

Read more about treating pilonidal sinus.

Useful Links

Published Date: 2013-08-06 10:18:08Z
Last Review Date: 2012-11-20 00:00:00Z
Next Review Date: 2014-11-20 00:00:00Z

Classification: Pilonidal sinus

NHS Choices Syndication

Representations

/conditions/articles/pilonidal-sinus/treatment

Pilonidal sinus

Treating a pilonidal sinus

[Original article on NHS Choices website]

Treatment may not be necessary for a pilonidal sinus if it’s not infected.

It is important to keep the area as clean and dry as possible. Removing hair from the area is also advisable, usually by shaving or using hair removal creams. This should reduce the risk of an infection.

If your pilonidal sinus does become infected, surgery is likely to be recommended.

Incision and drainage

Incision and drainage involves opening the sinus up and draining away the pus. This procedure can usually be carried out at your local hospital under general anaesthetic, so you will be asleep during the operation.

It’s a relatively minor operation, so you should be able to return home either the same day or the day after the procedure.

After the operation, a dressing is applied to help the wound heal. It should be arranged for your dressing to be changed daily by the practice nurse at your local GP surgery. See the advice below for tips on how to look after your wound.

Treating recurring infection

When there is discharge of pus from the sinus without an abscess, antibiotics may be prescribed to keep the infection under control while you wait to see a surgeon. This will not cure the pilonidal sinus, however.

If the pilonidal sinus keeps becoming infected, surgery may be recommended to remove the sinus and prevent further infections. This can be done in a number of ways. In most cases, operations called wide excision or excision and primary closure are used.

Wide excision

During wide excision, the surgeon cuts out the section of skin containing the sinus. The wound is left open and packed with a dressing.

The advantage of having a wide excision is that the chances of infection returning are low. But the wound will take a long time to heal and your dressings need to be changed daily for two or three months.

Excision and primary closure

During an excision and primary closure, the surgeon cuts out the section of affected skin before closing and sealing the wound with stitches. The advantage of this technique is that the wound heals quickly. However, the chances of the infection returning are higher than with a wide excision.

There are different methods of using a flap of your own skin and tissue to fill and close the wound. Your surgeon can explain the technique they will use in more detail.

Fibrin glue

Some pilonidal sinuses can be treated by scraping away ingrown hairs and other debris from the sinus, before sealing the area with a special absorbable glue called fibrin glue. This can be done under general or local anaesthetic, depending on your preference.

The advantage of this treatment is that you do not need any dressings and there is little pain. You will probably be able to return to normal activities within a week. The risk of infection is similar to excision and primary closure. However, this procedure is relatively new and may not be available in your local area.

After surgery

You may feel some discomfort after your operation. You should be given pain relief and you may also be given painkillers to take at home. You will usually be discharged on the day of your operation.

After your operation, you will probably need time off work, although this will depend on how you are feeling and the type of work you do. Avoid strenuous work for up to two weeks.

You can start to exercise and play sport as soon as you feel able to. However, if you have stitches, you may need to avoid activities that could disrupt the stitches for two to four weeks.

Wound care

Whatever type of operation you have, it is important to keep the site of the wound clean. Your surgeon can advise about how to do this, which may include the following points:

Have a shower or bath at least once a day if your wound is being left open and packed with a dressing.
If your wound is closed with stitches, avoid having a bath. You may be advised to keep the wound completely dry for the first few days. Ask your surgeon for advice.
When washing the wound, do not use soap because this will irritate your skin. Use plain water and a soft cloth instead.
Do not use talcum powder.
Carefully dry the area after washing using a soft towel, but do not rub the skin. Using a hair dryer is a good way of drying the area.
Always remove a damp or wet dressing and replace it with a dry, clean one.
Wear loose-fitting cotton underwear and avoid synthetic underwear, such as nylon.
Eat high-fibre foods to help soften your stools and reduce any straining when you go to the toilet.

Complications

Several complications can occur as a result of surgery for a pilonidal sinus. These include:

recurrent pilonidal sinus (pilonidal sinus returning after treatment)
infection at the site of the wound during or after surgery

Contact your GP immediately if you notice any signs of infection, such as:

pain
red, swollen skin
a high temperature of 38ºC (100.4ºF) or above
a feeling of heat at the site of the wound
fluid, pus or blood leaking from the site of the wound
an unpleasant smell coming from the site of the wound

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Published Date: 2013-08-06 10:48:41Z
Last Review Date: 2012-11-20 00:00:00Z
Next Review Date: 2014-11-20 00:00:00Z

Classification: Pilonidal sinus

Pilonidal sinus

Pilonidal sinus

Causes of a pilonidal sinus

Hair follicles

Infection of the pilonidal sinus

Increased risk

Jeep seat

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Pilonidal sinus

Introduction

Who is affected?

Why do pilonidal sinuses happen?

How are pilonidal sinuses treated?

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