Pilonidal Sinus
Pilonidal Sinus


The name of the disease comes from the Latin word Pilu (hair) and Nidus (nest). 

Dead skin debris spilling from the back area is a disease caused by nesting of hairs and hairs in the region of the coccyx. 

It is generally known as the disease of young adult men.


There are two theories in the formation of the disease. The first is that the skin in the area where the event begins is sensitive and the existing hairs are pushed into the skin by friction, the second is the dead skin residues clogging the exit points of the hair and the hair grows inwardly and not inward. 

For this reason, pilonidal disease is not only seen in the tail, but also in the beard, bikini area, armpits and legs. Among these, the most problematic in terms of the patient is those that are located in the coccyx. Inwardly growing hairs are responded to by an inflammatory reaction in the body and become a cocoon-shaped cyst. 

The diameter of the cyst is variable. It can even be thought of as an iceberg. The greater the number of holes in the midline (the sinus mouth), the greater will be the spread of the disease in the base. 

Generally, in very advanced patients, the depth of the base may continue to the membrane of the coccyx, while the width will be different for each patient and the period of the disease.


Patients often present with itchiness in the coccyx, yellow colored and malodourous discharge, sometimes contamination of the clothes due to bleeding, and stiffness. Discoloration is typical in this region. 

When the hips are lying in the supine position, one or more holes (sinus mouths) appear on the coccyx. Even when pressed, yellow discharge may occur. Over time, the number of sinus mouths is increasing and the disease is spreading towards the skin on the hips. 

If there is excessive pressure or exposure to trauma in the area with pilonidal sinus, abscess will be seen. Sometimes the disease manifests itself as abscess. It is noticeable that there is a stiffness in the tail, which is very painful, reddened and swollen. This abscess is either self-emptying or surgically evacuated.


As a general treatment approach, the patient should be informed about the methods and the most appropriate treatment method should be decided together according to the stage of the disease. In patients with early period who present only with complaints such as discharge and pruritus, pit picking + laser closure may be applied.

Here, under local anesthesia, the sinus mouths are removed and the cyst contents are cleared and the remaining area is closed with the help of a laser which is laser at the end. It is possible for the patient to return to normal life after a little rest.  

Microsinissectomy may be preferred in early stage patients. Under local anesthesia, the sinuses are removed with a 1-2 cm incision and the skin is closed with sutures. The patient may return to his daily life the same day.

Surgical techniques are planned for patients with a large number of sinuses, a history of abscess, and long-standing complaints, considering that the disease is widespread and complicated.

Ask to Op. Dr. Mehtap Ertürk

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