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Pilonidal sinus

Sinus pilonidalis · Pilonidální sinus

What it is

Hairs drill into the skin of the cleft above the buttocks, forming a pit that abscesses again and again; mostly young hairy men who sit a lot.

Symptoms & signs

  • Pain and swelling at the top of the buttock cleft
  • pus discharge
  • small pits in the midline
  • recurrent abscesses

🚩 Get help if…

  • call 112 / 911 now Fever with fast-spreading redness and feeling very unwell
  • see a doctor soon Painful, hot, swollen lump above the buttocks
  • see a doctor soon Pus or blood leaking from a pit in the cleft
  • see a doctor soon Wound after surgery not healing after weeks

Where it strikes

Medical treatment

  • Drainage of an acute abscess
  • pit-picking (Bascom) for simple disease
  • off-midline flap closure (Karydakis, Limberg)
  • avoid wide open excision where possible

Natural & lifestyle

  • Keep the cleft hair-free (laser or clipping)
  • hygiene and dry skin
  • avoid long sitting

Emerging & experimental

  • Laser (SiLaC) and endoscopic treatment (EPSiT)
  • phenol injection
  • fibrin glue

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Honey dressings on open wounds — small studies of faster healing early / small studies
  • Tea tree oil and turmeric — anecdotal anecdotal / traditional
  • Squeezing or draining at home — risks spreading the infection anecdotal / traditional

ICD codes