In Ayurveda, pilonidal sinus is referred to as Nadi Vrana, which involves the formation of a sinus or tract in the natal cleft region, usually filled with pus and debris. Ayurveda approaches the treatment of pilonidal sinus holistically, aiming to address the underlying imbalance in the body's doshas (energetic forces) and promoting wound healing through natural means.Ksharsutra therapy is a well-established Ayurvedic treatment method for various sinus conditions, including pilonidal sinus. Ksharsutra is a medicated thread prepared from specific herbs and alkaline substances. The thread is inserted into the sinus tract under local anesthesia and periodically tightened to promote gradual cutting, healing, and removal of the sinus tract.The efficacy of Ksharsutra therapy lies in its ability to debride the sinus tract, induce tissue healing, and prevent recurrence. The alkaline properties of the Ksharsutra help in necrotizing the unhealthy tissue, promoting granulation, and stimulating the formation of healthy tissue. Additionally, the herbs present in the thread possess antimicrobial and anti-inflammatory properties, aiding in the resolution of infection and inflammation associated with pilonidal sinus.Ayurveda also emphasizes the importance of lifestyle modifications and dietary changes to support the healing process. This may include dietary recommendations to balance the doshas, promote digestion, and enhance tissue regeneration. Patients are often advised to consume a diet rich in fresh fruits, vegetables, whole grains, and herbal supplements to boost immunity and accelerate wound healing.Moreover, Ayurveda recommends maintaining proper hygiene of the affected area to prevent infection and recurrence of pilonidal sinus. Regular cleansing with medicated herbal formulations and avoiding prolonged sitting or pressure on the natal cleft can help in preventing aggravation of the condition.In conclusion, Ayurveda offers a comprehensive approach to the management of pilonidal sinus through Ksharsutra therapy, dietary modifications, lifestyle changes, and hygiene practices. By addressing the root cause of the condition and promoting natural healing mechanisms, Ayurveda aims to provide long-term relief and prevent recurrence of pilonidal sinus. However, it is important to consult a qualified Ayurvedic practitioner for personalized treatment recommendations and guidance.