Medical Q&As

Pilonidal sinus - keeps recurring?

I suffered a pilonidal sinus over two years ago. It burst before I got to the hospital. It was cleaned and packed with disinfectant everyday for several weeks. Occasionally the area of the cavity flares up again. It becomes uncomfortable to sit and is tender to touch, but is not swelled and infected as it was prior to my hospitalisation. Sometimes there is slight bleeding in the area. Is this normal and should I see a doctor about it? The discomfort is bearable and usually passes in a day or two.

I think you should return to your GP and have this matter re-assessed. Pilonidal sinuses can result in recurrent bouts of infection and can lead to abscess formation which can be extremely painful. Pilonidal sinuses look like a small pore in the skin and they usually occur in the natal cleft which is located between the cheeks of the buttocks. They occur in young adults and are rarely seen over the age of forty. The condition is 4 times more common in males than females. Infection usually begins with inflammation of a hair follicle in the natal cleft which in turn leads on to the formation of an abscess or sinus. Then a hair becomes trapped in the cleft and enters the sinus or pore-like structure, which in turn generates a reaction in the immune system that is technically referred to as a foreign body reaction. This particular type of reaction is exactly the same process that occurs when the body reacts against the presence of a thorn or splinter in the skin. In other words the immune system reacts against the hair in the natal cleft as if it were a foreign body. This process tends to recur periodically and is unlikely to resolve without surgical intervention. I would advise you to see your GP with a view to being referred to a surgeon in order to have this matter dealt with definitively.