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Is surgery mandatory for my pilonidal sinus?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

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?

Please help.

Thank you.

Answered by Dr. Madhav Tiwari

Education:

MBBS

Professional Bio:

Dr. Madhav Tiwari is a skilled Urologist and General Surgeon who is an expert and has a special interest in urological oncology. He specialises in performing complex robotic and minimally invasive surgeries. He is renowned for his precise surgical techniques and a patient-first approach that prioritizes both effective treatment and patient comfort. He is dedicated to providing high-quality care for a range of urological and surgical conditions. He has treated thousands of patients and remains committed to delivering personalized, compassionate care and exceptional outcomes.

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome to icliniq.com.

A pilonidal sinus is more common among men who:

1. Have more hard body hair.

2. Have long working hours (sitting down).

3. Obese.

Please do a Sinogram.

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.

I hope this helps.

Thank you.

Patient's Query

Hello doctor,

Thank you for your reply.

May I know various creams for the pilonidal sinus?

Please help.

Thank you.

Answered by Dr. Madhav Tiwari

Education:

MBBS

Professional Bio:

Dr. Madhav Tiwari is a skilled Urologist and General Surgeon who is an expert and has a special interest in urological oncology. He specialises in performing complex robotic and minimally invasive surgeries. He is renowned for his precise surgical techniques and a patient-first approach that prioritizes both effective treatment and patient comfort. He is dedicated to providing high-quality care for a range of urological and surgical conditions. He has treated thousands of patients and remains committed to delivering personalized, compassionate care and exceptional outcomes.

This doctor is not available for online consultations on the platform anymore.

Hi,

Welcome back to icliniq.com.

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.

I hope this helps.

Thank you.

Medically reviewed by Dr. Divya Banu M
Published At May 8, 2019
Reviewed At December 22, 2025

Education:

MBBS

Professional Bio:

Dr. Madhav Tiwari is a skilled Urologist and General Surgeon who is an expert and has a special interest in urological oncology. He specialises in performing complex robotic and minimally invasive surgeries. He is renowned for his precise surgical techniques and a patient-first approach that prioritizes both effective treatment and patient comfort. He is dedicated to providing high-quality care for a range of urological and surgical conditions. He has treated thousands of patients and remains committed to delivering personalized, compassionate care and exceptional outcomes.

This doctor is not available for online consultations on the platform anymore.

Education:

BDS

Professional Bio:

Dr. Divya Banu M is a dedicated Dental Surgeon with valuable clinical experience. She specializes in the diagnosis, prevention, and treatment of various diseases and conditions affecting the oral cavity. With a gentle and patient-centered approach, she is committed to promoting oral health and enhancing smiles through quality dental care. Her areas of expertise include restorative dentistry, preventive dental care, and cosmetic dental procedures.

This doctor is not available for online consultations on the platform anymore.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Education:

MBBS

Professional Bio:

Dr. Madhav Tiwari is a skilled Urologist and General Surgeon who is an expert and has a special interest in urological oncology. He specialises in performing complex robotic and minimally invasive surgeries. He is renowned for his precise surgical techniques and a patient-first approach that prioritizes both effective treatment and patient comfort. He is dedicated to providing high-quality care for a range of urological and surgical conditions. He has treated thousands of patients and remains committed to delivering personalized, compassionate care and exceptional outcomes.

This doctor is not available for online consultations on the platform anymore.

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