Is it mandatory to get surgery immediately for pilonidal sinus?

Q. What are the treatment options available for pilonidal sinus?

Answered by
Dr. Madhav Tiwari
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on Apr 04, 2019

Hello doctor,

I have a pilonidal sinus, that is 20 mm long. I consulted the surgeon and he suggested surgery. Is it mandatory to get the surgery done now itself or can I wait for three to four months?



Welcome to

A pilonidal sinus is more common among men who:

1. Have more hard body hair.

2. Have long working hours (sitting down).

3. Obese.

Unfortunately, surgery is the best option for you in going forward. However, as the recovery period can be a lengthy one, you may hold off on surgery for a few months provided the discharge from the sinus is not bothering you too much and is not painful. Whilst you decide on when to get it operated, you should continue to maintain local hygiene, keep the area as dry as possible, and remove any hair in the area.

That being said, the longer you leave it, the more problematic it might become due to infection, and worsening of the sinus. If you do not wish to undergo a surgical procedure, there is the option of opting for laser treatment or trying various creams. I should warn you that either of these is less successful than treating it surgically.

Investigations to be done:


Preventive measures:

Maintain local hygiene, Shave hair from the region. Keep the area dry.

Thank you doctor,

May I know various creams for pilonidal sinus?



Welcome back to

How are you doing? You can use T-Bact ointment (Mupirocin) or Metro-P ointment (Metronidazole). However, surgery is the best way of going forward.

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