Cyst Characteristics, Causes and Treatment Options in Singapore
Pilonidal sinus disease can cause persistent discomfort and recurrent infections if left untreated.
At VEC Specialists, our general surgeons provide assessment and treatment tailored to the severity of your condition, from early conservative care to definitive surgical removal when required.
What is a Pilonidal Sinus?
A pilonidal sinus is a chronic skin condition that develops in the crease between the buttocks, near the tailbone (coccyx). It occurs when hair and debris become trapped beneath the skin, forming a small tunnel (sinus tract) that can become infected.
While some cases remain mild initially, a pilonidal sinus may progress to recurrent infections or abscess formation if left untreated.
Characteristics & Symptoms of a Pilonidal Sinus
A pilonidal sinus may present differently from person to person, depending on whether it is mild, infected or recurrent. Common characteristics and symptoms include:
- Pain or tenderness near the tailbone
Discomfort is usually felt in the crease between the buttocks and often worsens when sitting or during prolonged pressure on the area. - Swelling or redness in the buttock crease
The skin may appear inflamed, warm, or swollen, particularly during an active infection. - Discharge from a small opening in the skin
Pus, blood, or clear fluid may ooze from the sinus opening, sometimes staining clothing or causing persistent dampness. - Foul-smelling drainage
Infected pilonidal sinuses often produce an unpleasant odour due to trapped debris and bacterial growth. - Recurrent flare-ups or abscess formation
Symptoms may settle temporarily but return repeatedly, especially if the underlying sinus tract remains untreated. - Fever or general unwellness (in more severe cases)
This may occur when infection spreads or an abscess forms and requires prompt medical attention.
If these symptoms persist or recur, early assessment is recommended to reduce the risk of ongoing infection and more extensive treatment.
What Causes a Pilonidal Sinus?
Loose Hairs Penetrating the Skin
Hair shed from the scalp or surrounding areas can collect in the buttock crease. Repeated pressure and movement may push these hairs into the skin, where they act as a foreign body and trigger inflammation.Friction and Prolonged Sitting
Activities that involve prolonged sitting or repetitive friction, such as office work or driving, can increase pressure on the tailbone area, making it easier for hair to embed into the skin.Inflammatory Reaction to Trapped Hair
Once hair becomes embedded, the body may react to it as foreign material. This inflammatory response can lead to the formation of a cyst or sinus tract beneath the skin.Moisture and Poor Ventilation
The natal cleft is a warm, moist area that may not ventilate well. These conditions can promote bacterial growth and increase the risk of infection.Recurrent Infection and Scarring
Repeated episodes of inflammation or infection can cause scarring and deeper sinus tracts, making the condition more chronic and less likely to resolve without treatment.Who is at Risk of Developing a Pilonidal Sinus?
A pilonidal sinus can affect anyone, but it is more commonly seen in males and young adults, particularly those between 15 and 35 years of age. This is thought to be related to hair growth patterns and skin characteristics.
People who spend long periods sitting, such as office workers or drivers, may be at higher risk due to repeated pressure and friction over the tailbone area.
Those with coarse or excessive body hair are also more susceptible, as loose hairs can more easily become trapped and penetrate the skin.
Wearing tight-fitting clothing that increases friction, as well as having a family history of pilonidal sinus, may further increase the likelihood of developing this condition.
Importantly, pilonidal sinus disease is not caused by poor hygiene alone and can occur despite good personal care.
When Should You See a Doctor?
You should seek medical attention if you experience persistent pain, swelling, or discharge near the tailbone, especially if symptoms recur or worsen over time.
The presence of fever, increasing redness, or severe tenderness may indicate an active infection or abscess that requires prompt treatment.
Early assessment is also recommended if symptoms return despite antibiotics or home care. Timely treatment may help prevent repeated infections and reduce the need for more extensive surgery.
How is a Pilonidal Sinus Treated?
Treatment for a pilonidal sinus depends on the severity, frequency of infection, and whether the condition is acute or recurrent. Your surgeon will recommend an approach tailored to your individual condition.
Non-Surgical Management (Early or Mild Cases)
In early or minimally symptomatic cases, treatment may focus on controlling infection and reducing irritation. This may include antibiotics to manage infection, along with good hygiene and regular hair removal around the affected area.
While these measures may relieve symptoms temporarily, they do not eliminate the underlying sinus tract and recurrence remains possible.
Drainage of a Pilonidal Abscess
If the pilonidal sinus becomes infected and forms an abscess, a minor surgical drainage procedure may be performed under local anaesthesia:
This helps to relieve pain and control infection by releasing trapped pus. However, abscess drainage is not considered definitive treatment for chronic pilonidal sinus disease, as the sinus tract may still remain.
Pilonidal Sinus Removal Surgery (Definitive Treatment)
For recurrent or chronic pilonidal sinus disease, surgical removal of the sinus tract is often recommended to reduce the risk of future infections:
The surgical approach depends on the extent of the disease and may involve excision of the affected tissue with appropriate wound closure techniques.
Your surgeon will discuss the most suitable option based on your condition, previous episodes, and recovery considerations, with the aim of achieving long-term resolution and lower recurrence rates.
Recovery After Pilonidal Sinus Surgery
Recovery following pilonidal sinus surgery varies depending on the procedure performed. Most patients can expect a period of wound care and dressing changes, along with temporary limitations on prolonged sitting or strenuous activity.
With appropriate aftercare, many individuals are able to return to work and daily activities within a few weeks. Maintaining good hygiene and hair control during recovery is important, as this helps reduce the risk of recurrence and supports proper healing.
Fuss-Free and Safe Pilonidal Sinus Removal
We understand that pilonidal sinus disease can be uncomfortable and disruptive. At VEC Specialists, we provide treatment for pilonidal sinus guided by experienced surgeons and tailored to your condition, whether this is your first episode or a recurrent problem.
Care is delivered in a non-judgmental and professional environment, with a focus on safe treatment and long-term outcomes.
Arrange a consultation to explore your treatment options.
Patient Information
How serious is a pilonidal sinus?While not usually life-threatening, a pilonidal sinus can be very painful and significantly affect your quality of life. If left untreated, it may lead to recurrent infections and abscess formation. |
What happens if it’s left untreated?An untreated pilonidal sinus can repeatedly become infected, forming abscesses that cause severe pain, swelling, and pus discharge. Over time, chronic infection may also lead to multiple sinus tracts, making surgical treatment more complex. |
Can a pilonidal sinus heal on its own?In some very mild cases, symptoms may improve temporarily with good hygiene. However, most pilonidal sinuses do not heal on their own and require medical or surgical treatment to reduce the risk of recurrence. |
What’s the difference between a pilonidal sinus and a cyst?A pilonidal sinus is a tract (tunnel) that often contains hair and debris, while a pilonidal cyst refers to the sac itself. Although the terms are often used interchangeably, “sinus” usually implies a more chronic condition with a persistent tract. |
Can a pilonidal sinus turn cancerous?This is extremely rare, but long-standing, untreated pilonidal sinuses have been associated with a slightly increased risk of skin cancer (squamous cell carcinoma). This is one reason why early assessment and treatment are recommended. |
Can a pilonidal cyst come back after removal?Yes, pilonidal cysts can recur even after surgical removal and complete wound healing. This may be influenced by genetic predisposition or lifestyle factors that contribute to the condition. To reduce the risk of recurrence, it is important to keep the affected area clean and dry. Regular shaving or hair removal around the tailbone and buttocks may also help prevent hair and debris from accumulating, which are common triggers for pilonidal sinus disease |
