Pilonidal Sinus is a hole or cyst in skin at the top of the cleft of the buttocks or cleavage between the buttocks. Cyst is usually filled with pus or fluid. It contains hairs and dirt that may lead to infection. The main causes of pilonidal sinus are harmonal changes after puberty, hair growth, friction from clothes, thick and curly body hairs, sedentary. Friction of clothes due to sitting for long hours, causes hairs to burrow back under the skin and cyst is created around hairs under the skin. It becomes infected with time.

The following are the signs of infection:

    Pain during sitting and standing
    Redness around the skin
    Swelling of cyst
    Pus or blood draining from the abscess

Treatment of pilonidal sinus:
If the infection lies dormant then no treatment is required. In the silent phase, only precautions are required which are as follows:

    Avoid sitting for long hours
    Clean the area and make it dry
    Remove hair from that portion using razor or hair removal cream.

When there is discharge from pilonidal sinus, then only surgery is required.

The following methods are used for treatment of pilonidal sinus:

    Wide excision of pilonidal sinus: In this wide bore local excision is done and resulting cavity is left open. It is healed by doing dressings daily, but healing process takes about 3 months.
    Laser Pilonidoplasty (LPP): In this, instead of wide excision, small cut is made and all the pus is drained out. Then tract is seal with laser fiber. It takes only 6-8 weeks for healing process and there is no recuurence rate using this procedure.
    Excision with primary Closure: In this sinus is removed using surgical procedure and then sealed using stiches. But in this chances of infection are 20-25%.
    Limberg FLAP or Gluteal FLAP: It is done in patients who have extensive pilonidal sinus. The surgeon removes an oblong shaped plug containing the abscess, skin and fat, thus creating a cavity. To fill the cavity, a flap of skin and thick fat is mobilised from the buttock beside and below the cavity.

This procedure takes long time for recovery after surgery and is quite invasive. The patients are hospitalised for couple of days after surgery.

One of the above treatment method that is Laser Pilonidoplasty (LLP) was introduced in India by renowned proctologist Dr. Ashwin Porwal at Healing Hands Clinic. It is one of the leading clinics in India for the treatment of anorectal disorders like hernia, piles, constipation, fissure, fistula, circumcision, pilonidal sinus and others. The clinic has various centers at Pune, Bengaluru, Mumbai and Nashik. All the centers have well qualified and experienced doctors who have successfully treated number of patients suffering from these diseases.

Author's Bio: 

Proctoligist at Healing Hands Clinic