20 doctors weighed in:
What is the treatment of pilonidal sinus?
20 doctors weighed in

Dr. Otto Placik
Surgery - Plastics
5 doctors agree
In brief: Depends on extent
Depending on the extent, a variety of treatments are available.
Many will heal on their own if small with conservative wound care and hygiene. Larger infected cysts may initially may require further opening to allow drainage. Recurrent cysts may eventually require complete excision with some of the wounds closed primarily whereas others may be left open to heal slowly over time. Some use flaps.

In brief: Depends on extent
Depending on the extent, a variety of treatments are available.
Many will heal on their own if small with conservative wound care and hygiene. Larger infected cysts may initially may require further opening to allow drainage. Recurrent cysts may eventually require complete excision with some of the wounds closed primarily whereas others may be left open to heal slowly over time. Some use flaps.
Dr. Otto Placik
Dr. Otto Placik
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4 doctors agree
In brief: Infected?
Abx will NOT cure a pilonidal sinus/cyst.
They can help clear the infection and surrounding cellulitis that can occur when the cyst becomes infected. .... but not the cyst itself. The cyst needs to be removed if bothering you. If not bothering you can be safely watched.

In brief: Infected?
Abx will NOT cure a pilonidal sinus/cyst.
They can help clear the infection and surrounding cellulitis that can occur when the cyst becomes infected. .... but not the cyst itself. The cyst needs to be removed if bothering you. If not bothering you can be safely watched.
Dr. Erik Borncamp
Dr. Erik Borncamp
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Dr. Joseph Eastern
Dermatology
4 doctors agree
In brief: Time or surgery
A substantial percentage of pilonidals resolve spontaneously; but it takes a long time.
If you don't want to wait, or the pain level is too high, surgery is the best option. It's a fairly simple operation, but usually done in the hospital. Be aware that recurrences are common, even after surgery.

In brief: Time or surgery
A substantial percentage of pilonidals resolve spontaneously; but it takes a long time.
If you don't want to wait, or the pain level is too high, surgery is the best option. It's a fairly simple operation, but usually done in the hospital. Be aware that recurrences are common, even after surgery.
Dr. Joseph Eastern
Dr. Joseph Eastern
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1 comment
Dr. Mark Gordon
Surgery is outpatient,often in an ambulatory center. The procedure should be of the minimal type, with pit excision and drainage. This allows return to work in a few days,with minimal morbidity. Since there is recurrence (new pit disease develops),wide excision procedures should be avoided, as they have significant morbidity. You may wish to look up the articles of Dr Bascom.
Dr. Richard Zienowicz
Surgery - Plastics
1 doctor agrees
In brief: Remove it
The sinus tract needs to be excised.
Problems arise when the offending tissues are incompletely removed. This is typically done by a general surgeon.

In brief: Remove it
The sinus tract needs to be excised.
Problems arise when the offending tissues are incompletely removed. This is typically done by a general surgeon.
Dr. Richard Zienowicz
Dr. Richard Zienowicz
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Dr. Stephen A. Pap
Surgery - Plastics
In brief: Excision
It is very difficult to treat these kinds of cysts, without a radical approach, excising the cyst structure, and closing off the drainage.
I have seen many patients over the years who have been treated less aggressively, and the problem only continues, with the patient getting very frustrated. It's not a huge operation, or very debilitating, but it should be done early rather than late.

In brief: Excision
It is very difficult to treat these kinds of cysts, without a radical approach, excising the cyst structure, and closing off the drainage.
I have seen many patients over the years who have been treated less aggressively, and the problem only continues, with the patient getting very frustrated. It's not a huge operation, or very debilitating, but it should be done early rather than late.
Dr. Stephen A. Pap
Dr. Stephen A. Pap
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Dr. Tara Passow
Dermatology
In brief: Surgery
I think it's likely that the best way to treat a pilonidal sinus is with surgery.

In brief: Surgery
I think it's likely that the best way to treat a pilonidal sinus is with surgery.
Dr. Tara Passow
Dr. Tara Passow
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