Dr. Srikanth Marla Chinthamani
General Practitioner
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I think I am having pilonidal sinus at my lower back just above the butt crack. It appeared a month ago and is a pea-sized bump oozing out pus-like substance. Please suggest medication to treat it early.
Hello,
Welcome to icliniq.com.
Based on your history and the picture (attachment removed to protect the patient's identity), it appears you have pilonidal sinus with a granuloma.
Can you give me a few more details? Do you have any fever or pain at the site? Because I would like to rule out any abscess formation at the site.
It requires excision with a skin flap or graft. If there is an abscess, then you need to drain it first. Consult a surgeon for this procedure.
The Probable causes
Differential diagnosis
Probable diagnosis
Patient's Query
Thank you doctor,
I do not have any fever but a little pain while sitting or touching it, or squeezing it. Can it be treated with medication, antibiotics, or anything? As surgery is my last option. Please suggest or prescribe medications to cure it.
Hello,
Welcome back to icliniq.com.
The problem is once a sinus has already formed, only excision can truly remove the disease. But it is not an emergency, as long as it is not bothersome and there is no abscess formation. You can wait and get an elective procedure.
I will prescribe medication for pain. But I would recommend you go for a planned surgery whenever it is possible, so that you do not get abscess formation or multiple sinus development.
Laser treatment is another option available now.
I would suggest you get a physical examination from a surgeon to confirm the diagnosis and proceed further.
Treatment plan
Preventive measures
Regarding follow up
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General Practitioner
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