What is the appropriate treatment for a pilonidal sinus?

Question

Hi doctor,

I think I am having a pilonidal sinus in my lower back, just above the butt crack. It appeared a month ago and is a pea-sized bump oozing pus-like substance. Please suggest medication to treat it early.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Based on your history and the picture (attachment removed to protect the patient's identity), it appears you have a pilonidal sinus with a granuloma.

Can you give me a few more details? Do you have any fever or pain at the site? 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.

I hope this helps.

Kindly revert in case of further queries.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

The problem is that once a sinus has already formed, only excision can truly remove the disease. However, it is not an emergency, as long as it is not bothersome and no abscess formation occurs. You can wait and get an elective procedure.

I will prescribe medication for pain. Kindly take tablet Calpol (Paracetamol) 500 mg for pain, if it is bothersome twice daily after food. 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.

Also, keep the area clean and remove the hair around the area. 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. Kindly do a follow-up if there is pus discharge.

I hope this helps.

Kindly revert in case of further queries.

Thank you.