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Pilonidal Sinus — Frequently Asked Questions

  • Prof. Dr. Zahid Mahmood
  • August 3, 2026

Pilonidal Sinus — Frequently Asked Questions

Answered by Prof. Dr. Zahid Mahmood — General, Laparoscopic & Laser Surgeon, Lahore.

What exactly is a pilonidal sinus?

A small tunnel under the skin at the top of the buttock cleft, over the tailbone, usually containing hair, which becomes chronically infected. The name means “a nest of hair.”

Is it caused by poor hygiene?

Not directly. It is caused by hair working its way into the skin under friction. Good hygiene and hair removal help prevent and treat it, but having one does not mean you are unclean.

Is it an STD or contagious?

No. A pilonidal sinus is not sexually transmitted and cannot be caught from or given to anyone. It is a mechanical problem of hair and friction.

Who gets a pilonidal sinus?

Most often young men, especially those who are hairy, sit for long hours (students, drivers, office workers), and sweat — which makes it common in our climate.

Is it dangerous?

It is not usually dangerous, but it can cause recurrent painful abscesses and discharge that disrupt daily life. It is best treated properly rather than left to flare repeatedly.

Will it go away on its own?

Mild disease can settle with good hygiene and hair removal, and the condition tends to improve with age. Established or recurrent disease usually needs treatment.

Does draining the abscess cure it?

No. Draining relieves the acute pain and infection, but the underlying sinus remains and usually flares again. It should prompt proper assessment of the sinus.

Is the surgery painful, and will I have a big wound?

Modern laser and minimally invasive treatments cause relatively little pain with small wounds. Larger operations involve more, but off-midline flap techniques heal well with the scar off the midline.

Is laser treatment better?

For suitable patients, laser and minimally invasive treatments mean smaller wounds, less pain, and a faster return to work or study. Whether they suit you depends on how extensive your disease is.

How long is the recovery?

After minimally invasive or laser treatment, many people return to normal activity within days. Open surgery heals over several weeks with dressing changes. Your surgeon will advise for your procedure.

Why does it keep coming back?

Because hair can work its way back into the skin of the cleft. Preventing recurrence depends on keeping the area clean, dry, and hair-free — regular hair removal, especially laser hair reduction, is very helpful.

Is laser hair removal worth it?

For many young patients prone to recurrence, yes. Because hair is the root cause, durably reducing it addresses the underlying problem and is increasingly recommended.

Can women get it?

Yes, though it is much more common in men. The same treatments and prevention apply.

Could it be something else?

Usually the midline pits make it clear. But if the openings are off to the side or near the anus, or the disease is unusual, other conditions such as an anal fistula, hidradenitis suppurativa, or (in our region) tuberculosis are considered.

When should I see a doctor?

If you notice pits, discharge, pain, or swelling at the tailbone, especially if it recurs. Seek prompt care for a hot, very painful swelling with fever, which is likely an abscess needing drainage.

How do I book a consultation?

Call Prof. Dr. Zahid Mahmood on 0300 413 0159, or visit professorzahid.com.

This page is for general awareness and does not replace a personal medical consultation.

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