A tiny opening or tunnel in the skin that is prone to infection is called a pilonidal sinus. It usually forms in the cleft at the top of the buttocks.

More than 70,000 cases of pilonidal cysts are reported in the United States each year, which makes it a prevalent condition.

Because pilonidal cysts are more common in people who sit a lot, they received the nickname "Jeep driver's disease" during World War II.

Check if you have an infected pilonidal sinus

Most pilonidal sinus sufferers are unaware of their condition until symptoms arise from an infection.

An infection can result in pain and swelling at the top of the buttock cleft as well as the development of a pus-filled skin abscess. Hair, dirt, and debris are typically found inside a pilonidal cyst. It may ooze pus and blood, odor strongly, and cause excruciating pain.

Occasionally, an abrupt development of a pus-filled abscess can result in pain, swelling, and difficulty sitting.

Young adult men are most commonly affected by pilonidal sinus infections. Those who sit a lot, such as taxi drivers, are also more likely to experience it.

The signs of an infection include:

  • Pain when sitting or standing; 
  • Cyst swelling; 
  • Reddened, sore skin around the area; 
  • Pus or blood draining from the abscess, causing a foul odor; 
  • Hair protruding from the lesion; 
  • Formation of more than one sinus tract, or holes in the skin. 
  • A low-grade fever is possible, but it is much less common.

Urgent advice: Ask for an urgent appointment at Piles To Smiles if:

There is a tiny sore spot between your buttocks that is leaking pus, bleeding, or hurting. 

These signs and symptoms can appear suddenly, and frequently in a few days. These indicate an infection, so treatment is required. 

How is a pilonidal cyst treated?

A pilonidal sinus that is not infected

If there are no infection symptoms, a pilonidal sinus treatment is not required. "Watch and wait" will be the advised course of action. 

It's critical to regularly shower or take a bath to maintain a clean space between your buttocks. 

Unless your doctor instructs you otherwise, avoid shaving the area affected. 

Treatments for an infected pilonidal sinus

The following factors will determine how to treat an infected pilonidal sinus: 

  • Your symptoms 
  • The pilonidal sinus's size; 
  • If this is your first infection or if it recurs frequently 

An abscess that hurts and swells typically needs to be cut open and the pus removed. Antibiotics may also be required. 

For a pilonidal sinus, there are several treatment options with varying results. Surgery is frequently recommended for the Pilonidal Sinus. Still, there are many drawbacks to various surgical procedures (such as bed rest and hospitalization, staying away from routine work, potential surgical complications, high treatment costs, etc.) that force a fellow to consider possible non-surgical treatments for the Pilonidal Sinus that can ensure full recovery.

Non-surgical Pilonidal Cyst Treatment:

Ksharsutra Treatment for Pilonidal Sinus:

Pilonidal sinus is a disease with infection as the root cause of the problem even then antibiotics are not successful in treating the condition. As a result of prolonged foreign body reaction and infection in the Pilonidal sinus cavity, there occur fibrotic changes in the pilonidal sinus tissue and antibiotics could not penetrate this fibrotic tissue hence the failure of antibiotics to cure pilonidal sinus. 

Not only antibiotics all other types of medications are not successful in treating Pilonidal sinus, this makes some intervention treatment necessary for Pilonidal Sinus. 

Considering the difficulties and complications associated with surgery for the Pilonidal sinus (especially recurrence of the Pilonidal sinus after surgery) Ayurveda proposes parasurgical treatment namely Ksharsutra treatment for the Pilonidal sinus.

What is Ksharsutra Treatment for Pilonidal Sinus:

In Ksharsutra, Kshar is an alkaline, unique Ayurvedic medication made from herbs, and Sutra is the word for thread, meaning that Ksharsutra is medicinal thread. Kshar can pierce fibrotic tissue and remove unhealthy tissue from the sinus tract. Thread is simply a vehicle for delivering medicine to the pathology site. 

The sinus tract is ligated by this Ksharsutra. The medication in the Ksharsutra lasts for approximately a week, so until the sinus tract heals entirely, the old Ksharsutra needs to be replaced every week. 

Generally, Ksharsutra treatment is done under local anesthesia so you can go home after a rest of 2-3 hours after primary ligation of Ksharsutra in the Pilonidal sinus tract (Applying Ksharsutra in the Pilonidal sinus for the first time). No hospitalization or bed rest is required during Ksharsutra treatment for the Pilonidal sinus. The fellow can continue his/ her normal routine activities as usual during treatment.

Subsequent Ksharsutra change can be done without any anesthesia. Your Ksharsutra expert doctor will attach the new Ksharsutra to the old one and gently pull it so that the new Ksharsutra takes its place.

Pilonidal Cyst Recovery

Follow your doctor’s instructions about at-home care. Other tips:

  • Keep the area clean.
  • Do regular sitz baths and dressings as per the advice of your Ksharsutra specialist doctor for the Pilonidal sinus.
  • Check for any changes of concern.
  • Some discomfort or irritation is normal during Ksharsutra treatment for the Pilonidal sinus. It can be managed by taking a sitz bath/ applying some anesthetic/ soothing ointment/ taking some pain-relieving medicines. If it is very troublesome, speak to your doctor to manage it.
  • Keep your follow-up appointments with your doctor for Ksharsutra change.

A complete cure is possible, but remember that it will take some time and you need to be patient during treatment.

Going back to work

How soon can I return to work during/ after Ksharsutra Treatment for Pilonidal sinus:

  • Since Ksharsutra Treatment for Pilonidal sinus is done under Local anesthesia so there is no need for Hospitalization or bed rest during treatment. From the very next day of Primary ligation of Ksharsutra in the Pilonidal sinus; the fellow can join his/ her work.
  • Subsequent Ksharsutra change sitting is an OPD treatment. You need not to plan something, especially for it. You just go to the Ksharsutra Specialist doctor, get the ksharsutra changed, and return to work… 

Home Remedies for Pilonidal Sinus:

Can Pilonidal Sinus be treated by home remedies?

Home remedies for Pilonidal sinus cannot cure the Pilonidal sinus. The following recommendations will help you in easing the pain and discomfort associated with the Pilonidal Sinus.

  • Maintain local hygiene: you should clean the affected area regularly with some anti-septic solution. If required you can plan for shaving the area or hair removal.
  • Cotton underwear and clothing: you should prefer cotton undergarments and clothing over others.
  • Hot compresses: Apply hot wet compresses 2-4 times a day. Warmth will help pull out the pus thus allowing the sinus/ cyst to drain. This will relieve pain and swelling.
  • Sitz bath: Hot water tub bath is equally effective in relieving pain and swelling. You should sit in warm water in such a way that the sinus/ cyst is immersed in water.
  • Regular exercise: obesity is a causative factor in the Pilonidal sinus so regular exercise will not only help in prevention but also in easing the pain and swelling of the pilonidal sinus.

Prevention of Pilonidal Sinus

How can pilonidal cyst/ sinus be prevented?

To help prevent pilonidal cysts, try to:

  • Wash the area daily with a mild soap
  • Make sure all soap is removed
  • Achieve or maintain a healthy weight.
  • Avoid prolonged sitting.

What are the causes of a pilonidal sinus infection?

Although the exact cause of an infected pilonidal sinus is unknown, hair growth, hormonal changes (since the condition usually develops after puberty), and friction from clothing or prolonged sitting are thought to be contributing factors.

Sitting and other friction-producing activities can push the hairs in that area to burrow back beneath the skin. Because the body perceives this hair as foreign, an immune reaction is triggered against it.

This immune response creates the cyst that surrounds your hair. These hairs serve as a source of infection.

Men are more likely to have pilonidal sinuses due to their tendency for hair growth.

Long periods of sitting can also raise your risk of developing a pilonidal sinus.

Risk factors for Pilonidal Sinus

Who can get a pilonidal cyst?

  • A pilonidal cyst can affect anyone. The following factors may make you more susceptible to a pilonidal cyst:
  • Being a white male young adult. (Men are diagnosed with a pilonidal cyst three to four times more frequently than women.)
  • Falling within the age range of puberty to 40 (the average age range is 20 to 35).
  • Being overweight.
  • Leading a sedentary lifestyle.
  • Extended periods of sitting.
  • Possessing stiff, thick body hair.
  • Dressing too tightly, which may exacerbate the skin disease.

A Note from Piles To Smiles

While a pilonidal cyst does not pose a direct threat to your life, delaying treatment can make the cyst harder to cure and eventually become a chronic illness. Because of this, it is critical to have an examination as soon as you notice any pilonidal cyst symptoms. Always communicate openly with your doctor about your symptoms and concerns.

Pilonidal cysts are tiny lumps or sacs filled with fluid that develop along the top or buttock crease. You can attempt to "wait and watch" if the cyst is not painful. 

However, if you experience pain or the cyst appears to be infected, you should consult your doctor. The pilonidal cyst may be surgically removed or treated by your doctor. It is essential to understand the symptoms of pilonidal cysts because they can recur after surgery. Therefore, Ksharsutra Treatment is advised by Ayurveda for Pilonidal sinus. The procedure involves the ligation of Ksharsutra, a specially medicated thread, in the Pilonidal sinus. New Ksharsutras are then placed in the sinus every week until the sinus heals fully.