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Treatment of Pilonidal sinus
If you have pilonidal dents in your skin but no symptoms, treatment is not required. To avoid infection, keep the area clean, and dry well after washing.
When symptoms develop quickly and severely, in an acute infection, you will usually need an emergency operation to puncture (make a hole in) and drain the sinus of pus. You will need to go to hospital but depending on the operation you need, you might only need a local anaesthetic, and may be able to go home the same day.
For infections that keep coming back, your GP will usually advise an operation. For immediate relief while waiting for your surgery (as this is not an emergency operation), you can soak the area in warm water and take painkillers such as ibuprofen, which will also help ease the swelling. If you have a lot of hair in this area, your GP can advise you on the safest way to remove some of the excess, without causing further infection.
There are three main types of surgery:
- Wide excision – removing the skin from wide area around the sinus, and allowing it to heal without stitches. This method takes some time to heal, and dressings need to be changed regularly, but it means there’s a low chance of the infection coming back
- Excision and stitching – only removing the skin that contains the sinus, and stitching the edges back together. This method is quicker to heal, but there is more chance of re-infection.
- Plastic surgery techniques to remove the sinus and rebuild the skin. This is usually used if the sinus keeps coming back, or if it covers a large area.
Antibiotics don’t usually need to be taken as well as having surgery. Nor should they be used instead of an operation, because they won’t actually remove the sinus.
