An In-Depth Look at Pilonidal Sinus: Causes, Treatments, and Prevention!

In this blog post, we take a closer look at pilonid sinus, a condition that commonly occurs in the tailbone and can lead to painful symptoms. We will explore the causes of this condition as well as the various treatments, including the emerging technique of laser hair removal. In addition, we will discuss alternative treatment options so that you can make an informed choice about how to approach pilonidal sinus.

What is Pilonidal Sinus?

Sinus Pilonidalis is a condition characterized by the formation of a cavity or cyst in the tailbone region, also called the sacrococcygeal region. It is common in young adults and affects men more often than women. The term “sinus” refers to the cavity or passageway that forms and “pilonidalis” means “nest of hair” in Latin, as the condition is often associated with ingrown hairs.

Location and Symptoms: Pilonidal Sinus usually occurs in the buttock cleft, just above the coccyx. It can manifest as a small pit, an abscess, a painful swelling, or an open sore. Symptoms can range from mild to severe and may include:

  1. Pain: Patients often experience pain or discomfort in the affected area. This can range from a nagging pain to severe pain when sitting, standing or moving.
  2. Swelling and Redness: The area around the pilonid sinus may become swollen and red. In some cases, there may also be inflammation.
  3. Drainage: The cyst may drain pus, blood, or other fluid, which can lead to the formation of an abscess or an open woundd.
  4. Sensitivity and Itching: The affected area may be sensitive to the touch and may be accompanied by itching.

What are the causes?

It is believed to arise from a combination of factors, the most important of which involve the hair follicles in the sacrococcygeal region (the region above the tailbone).

There is a connection between hair follicles and the development of pilonid sinus: Hair follicles play a vital role in the development of pilonid sinus. This area often contains several hair follicles close together, and sometimes hairs can grow in or curl back into the skin. This can lead to irritation, inflammation and eventually the development of a pilonidal sinus.

Risk factors and possible triggers of the condition:

Several factors can increase the risk of developing Pilonid Sinus. Some important risk factors are:

  1. Hair structure: People with coarse and thick hair may have an increased risk, as these hairs can curl, grow in or get stuck in the hair follicles more easily.
  2. Prolonged sitting: Prolonged sitting or putting pressure on the sacrococcygeal area, such as in people who spend a lot of time in a sitting position, can increase the chance of developing Pilonidal Sinus. This is because the pressure and friction can affect hair growth and ingrowth.
  3. Excessive Sweating: Excessive sweating can contribute to the development of Sinus Pilonidalis. Sweat can irritate the skin and clog pores, increasing the likelihood of inflammation and ingrown hairs. However, a recent 2021 study suggested that pilonid sinus patients sweat less than the controlled group. Thus, sweating may have a protective effect in PSD rather than being a risk factor.
  4. Gender: Pilonidalis sinus is more common in men than in women. This may be related to hormonal factors and the thickness of the skin.
  5. Heredity: There is a genetic component associated with Sinus Pilonidalis. Having family members who have had the condition can increase the risk of developing it.

It is important to note that the exact causes of Sinus Pilonidalis are not yet fully understood. While the above factors are considered risk factors, it can also occur without known triggers.


It is important to emphasize that each treatment option has its own advantages and disadvantages, and the choice of treatment should be made in consultation with a dermatologist or surgeon. It is essential to discuss all aspects of treatment, including effectiveness, recovery time and potential complications, to make an informed decision that best suits your individual situation.

Traditional Treatment Methods For Sinus Pilonidalis:

There are several traditional treatment methods available for Pilonidal Sinus, the most common of which are surgical procedures. The two main surgical approaches are incision and drainage, and excision.

  1. Incision and drainage: This procedure involves making a cut in the affected area to drain the pus and fluid from the pilonid sinus. The goal is to reduce inflammation and relieve symptoms. While this procedure is relatively simple, the recovery process may take some time. It may be necessary to regularly clean the wound and change dressings until healing is complete.

Effectiveness: Incision and drainage can relieve the acute symptoms of Pilonidal Sinus and treat infection. However, it cannot guarantee that the condition will not return.

Recovery time: Recovery time varies from person to person, but it may take several weeks for the wound to heal completely and normal activities to resume.

Recovery time: Recovery time varies from person to person, but it may take several weeks for the wound to heal completely and normal activities to resume.

  1. Excision: Excision is a surgical procedure in which the entire affected area, including the pilonid sinus and surrounding tissue, is removed. This approach is more effective in preventing recurrence of the condition.

Effectiveness: Excision offers a higher chance of definitive cure and decreases the chance of recurrent episodes of Pilonidal Sinus.

Recovery time: Recovery time after excision may vary depending on the extent of the surgery and individual healing capacity. In general, it can take several weeks to months for the wound to heal completely.

Possible Complications: Although rare, complications such as bleeding, infection, scarring, or wound problems can occur with excision.

Laser hair removal:

Laser hair removal is an innovative treatment method that is increasingly used in the treatment of Sinus Pilonidalis. This technique uses concentrated light energy to reduce or remove unwanted hair. Although laser hair removal is traditionally associated with removing unwanted facial or body hair, it has also shown positive results in the treatment of Sinus Pilonidalis.

Benefits of laser hair removal for Sinus Pilonidalis:

  1. Reduction of hair growth: Laser hair removal targets the hair follicles in the affected area, reducing or stopping hair growth. By reducing hair growth, the chance of ingrown hairs and developing Sinus Pilonidalis can be reduced.
  2. Precision and Targeted Treatment: Laser hair removal allows the dermatologist to precisely target the treatment to the specific area of ​​the pilonidal sinus. This minimizes damage to surrounding tissues and increases the effectiveness of the treatment.

Mechanism of action of laser hair removal:

Laser hair removal uses controlled pulses of light that are absorbed by the pigment in the hair follicle. This causes the hair follicles to become damaged, inhibiting hair growth. The process is relatively painless and safe, with minimal side effects.

Possible results of laser hair removal:

  1. Reduction of symptoms: By reducing hair growth in the affected area, laser hair removal can help reduce the symptoms of Pilonidal Sinus, such as pain, swelling, and inflammation.
  2. Recurrence Prevention: By targeting the hair follicles in the affected area, laser hair removal can help prevent recurrent episodes of Pilonidal Sinus.

It is important to note that the results of laser hair removal for Sinus Pilonidalis may vary depending on the individual situation and the severity of the condition.

Endoscopic removal

An experiment is currently underway to remove the fistula from the inside, called endoscopic removal.

Endoscopic removal is an innovative approach currently being investigated for the treatment of fistulas. It uses endoscopic techniques to access the fistula and treat it from the inside. This method has several advantages and disadvantages, which are discussed below:

Benefits of Endoscopic Removal:

  1. Less invasive: One of the main advantages of endoscopic removal is that it is a less invasive procedure compared to traditional surgical procedures. No large incisions are required, resulting in smaller wounds and less tissue damage.
  2. Faster recovery: With no large incisions, recovery time is usually shorter compared to traditional surgery. This means that patients can resume their normal activities more quickly.
  3. Less pain and discomfort: Because there is less tissue damage, patients generally experience less pain and discomfort after the procedure. This can lead to a more comfortable recovery process.
  4. Less scarring: With endoscopic removal, the incisions are smaller, reducing the chance of visible scarring. This can be beneficial for patients who are concerned about cosmetic results.

Disadvantages of endoscopic removal:

  1. Technical Expertise: Endoscopic removal requires specialized skills and expertise from the practitioner. It is important to have an experienced surgeon familiar with this technique to ensure the best results.
  2. Limited applicability: Not all fistulas are suitable for endoscopic removal. The suitability of the procedure depends on several factors, such as the location and complexity of the fistula. Some cases may still require traditional surgery.
  3. Possible Complications: While endoscopic removal is generally considered safe, there are still risks of complications, such as bleeding, infection, and damage to surrounding structures. These complications are rare, but it is important to understand and discuss them with your healthcare provider.

It is essential to emphasize that endoscopic removal is still an area of ​​research and is not widely adopted in clinical practice.


Another method that is used is injecting the fistula with phenol. This procedure starts with enlarging the fistula openings, which can be done with the help of an appropriate biopsyist. Then the sinus is curetted, removing hairs, pus and hypergranulation. After thoroughly cleaning the cavity with hydrogen peroxide, phenol is injected into the cavity and left for about a minute. Before the injection, the surrounding skin is carefully protected with petroleum jelly. After the treatment, the phenol is neutralized with alcohol. If necessary, this procedure can be repeated two to three times.

The use of phenol aims to destroy the epithelium lining the inside of the fistula cavity. This helps to reduce inflammation and promote healing. Due to the destruction of the epithelium, the risk of recurrence of the fistula is reduced.

Injection of phenol is not routinely practiced and is only used in certain situations. It is very important to consult an experienced dermatologist or surgeon who is familiar with these techniques. They can assess the suitability and safety of injecting phenol for your specific situation.

Prevention and what you can still do yourself

It is also important to take preventative measures to reduce the risk of Sinus Pilonidalis. This includes shaving the area carefully, avoiding sitting for long periods, and regularly cleaning and keeping the sacrococcygeal area dry. More on shaving and razor bumps

In addition to medical treatments, there are also some home care measures that can help manage and prevent pilonid sinus.

The use of cosmetic products, such as antibacterial soaps and creams, can help maintain clean and healthy skin. These products can help remove bacteria and prevent infection in the affected area. However, it is important to choose mild products that do not irritate or dry out the skin.

While there are no specific dietary supplements that can directly cure pilonidal sinus, certain dietary supplements may help promote healthy skin and strengthen the immune system, which may indirectly aid in the treatment and prevention of pilonidal sinus. Here are some nutritional supplements that may be helpful:

  1. Vitamin C: Vitamin C is a powerful antioxidant involved in the formation of collagen, a protein essential for skin health and repair. It can also strengthen resistance to infections and reduce inflammation. Taking vitamin C supplements can aid in wound healing and reduce inflammation in the affected area. Foods rich in vitamin C include citrus fruits, berries and kiwis.
  2. Zinc: Zinc is a mineral important for healthy skin and tissue repair. It plays a role in immune function and may aid in wound healing. By taking zinc supplements, you may be able to promote the healing process and reduce the risk of infections. Foods rich in zinc include shellfish, red meat, nuts and seeds.
  3. Omega-3 fatty acids: Omega-3 fatty acids, such as those found in fish oil, have anti-inflammatory properties and may help reduce inflammation in the body. They may also improve immune response and promote skin health. Taking omega-3 supplements can potentially contribute to better overall health and support skin healing.

Taking omega-3 supplements can potentially contribute to better overall health and support skin healing. It is always advisable to speak with a medical professional before beginning to take any supplements, especially if you are already on medication or under treatment for other conditions.

It is also essential to follow good hygiene practices to reduce the chance of infection. cIt is also essential to follow good hygiene practices to reduce the chance of infection.

It is important to note that these home care measures may not be enough to completely cure pilonidal sinus. If you experience symptoms or the condition worsens, it is advisable to see a dermatologist or other medical professional for proper diagnosis and treatment.

Iconic Elements skin care tips

At Iconic Elements, we understand the importance of natural ingredients and effective skincare products.

Sinus Pilonidalis Skincare
  1. Provide a mild cleanse: Choose a gentle cleanser that does not irritate or dry out the skin. Natural ingredients, such as marshmallow root and avena sativa (oats), have calming properties and may help reduce inflammation.
  2. Use a soothing cream: A soothing cream can help reduce irritation and redness. Iconic Elements Calming Cream, with ingredients such as marshmallow root, ectoine and avena sativa, is specially formulated to soothe and calm the skin. These natural ingredients have anti-inflammatory properties and can help promote healthy skin.
  3. Hydrate the skin: Proper hydration is essential for skin recovery. Choose a natural moisturizer body cream that is rich in nourishing ingredients such as ceramide, squalane, glycerin and vegetable wax. These ingredients help strengthen the skin barrier, lock in moisture and protect the skin from drying out.
  4. Iconic Elements products do not contain microplastics: Microplastics are small plastic particles that can be present in many cosmetic products, such as scrubs and peels. It is important to avoid products containing microplastics as they can be harmful to the environment. Iconic Elements strives for sustainability and does not use microplastics in their products.
  5. Restore skin’s own acidity: The skin has a natural acidity that helps maintain a healthy skin barrier. It is important to use products that respect and restore the pH value of the skin. Iconic Elements products are pH balanced and help protect and balance the skin.
Picture of Dr. Francis Wu

Dr. Francis Wu

Dr. Francis Wu, een vooraanstaande dermatoloog, is de drijvende kracht achter Iconic Elements. Hij heeft sinds 2004 zijn expertise ingezet om een veilige en effectieve huidverzorgingslijn te creëren, geschikt voor zowel gezonde huid als huidproblemen. Iconic Elements, opgericht in 2016, is de eerste brede skincare lijn in Nederland ontwikkeld door een dermatoloog. Als medisch specialist streeft Dr. Wu naar het bevorderen van het welzijn van mensen door hoogwaardige en effectieve huidverzorgingsproducten te bieden. De proefdiervrije en vegan producten vermijden schadelijke chemicaliën en bevatten natuurlijke ingrediënten.
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