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Pilonidal sinus / Pilonidal cyst

Pilonidal Sinus Cyst - Symptoms & Treatment
Pilonidal sinus / Pilonidal cyst
Dr Tan Wah Siew
Dr Tan Wah Siew
Senior Consultant Colorectal Surgeon
MBBS, MMed (Surgery), FAMS, FRCSEd

A pilonidal sinus, also known as a pilonidal cyst, is a chronic skin infection in the crease between the buttocks near the tailbone (coccyx). This causes small tunnels in the skin, which usually contains hair.

What causes pilonidal sinuses?

The cause of pilonidal sinus is not completely understood but it is thought to be caused by hair getting embedded in the skin, causing irritation, infection and sometimes abscess formation.

Although anyone can get a pilonidal sinus, the following groups of people are at higher risk:

  • Men
  • People with excess body hair, particularly coarse or rough body hair
  • Obese people with higher body mass index (BMI)
  • People who sit for prolonged periods of time eg. Truck drivers

Symptoms

Symptoms can vary and may include:

  • Pus or bloody discharge from an opening in the skin
  • Pain, swelling and redness of the skin if an abscess develops
  • Small dimple in the skin
  • Fever

Diagnosis

The diagnosis of a pilonidal sinus can be achieved with careful clinical examination by the doctor. Rarely, a CT scan or MRI scan may be required for evaluation of this condition.

Treatment

The definitive treatment of a pilonidal sinus requires surgery as it rarely resolves without surgery. The type of surgery performed depends on the clinical condition of the patient, as well as the anatomy and complexity of the sinuses.

During and after surgical wound healing, the skin in the buttock crease must be kept clean and free of hair to decrease the risk of recurrence. This can be done by the following methods:

  • Shaving or waxing
  • Use of hair removal agents
  • Laser removal of hair follicles

The Surgical Options Include:

  • Drainage of abscess, sometimes requiring the use of negative pressure wound therapy in addition
  • Excision (removal) of the sinus with primary closure of the wound
  • Excision of the sinus and closure of wound with a flap
  • Laser closure (SiLaC procedure)
  • Endoscopic Pilonidal Sinus Treatment (E.P.Si.T)

During and after surgical wound healing, the skin in the buttock crease must be kept clean and free of hair to decrease the risk of recurrence. This can be done by the following methods:

  • Shaving or waxing
  • Use of hair removal agents
  • Laser removal of hair follicles

How can you prevent pilonidal sinuses?

The following measures may help to prevent the formation of pilonidal sinuses and/or keep them from recurring:

  • Keeping the area between the buttocks hair free
  • Losing weight (if you are currently overweight)
  • Avoiding prolonged pressure on the area eg. With prolonged sitting
  • Good personal hygiene and keeping the area clean and dry

Mount Elizabeth Medical Centre
#08-07, 3 Mount Elizabeth, Singapore 228510
Tel: 6454 0054 | Fax: 6764 0054 | Email: ask@surgicalassociates.sg

Gleneagles Medical Centre
#05-01, 6 Napier Road, Singapore 258499
Tel: 6471 0054 | Fax: 6271 0054

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