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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for pilonidal sinus

I have pilonidal sinus which I had surgery on 3 years ago. Lately it has re-emerged and is giving me a lot of trouble. it is inflaming and generating pus every month, i will then burst it, drain it, and clean it and it s ok for a month, then it starts accumulating again. I am clean and i use depilatory cream. Should fucidic acid help? or maybe a bactericidal? i m reluctant to do the operation again as I cannot afford such a long recovery period away from work...and with the 50% chance of it reappearing after surgery i don t think it s so worth it. Is there some possible remedy other than surgery? maybe some cream i could apply daily? Thanks!
Mon, 24 Aug 2015
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General Surgeon 's  Response

Hi,Dear,Thanks for your query to HCM virtual Clinic.
I studied your query in all the details put forth by you.
I understood your health concerns.

Cause and treatment of recurring pilonidal sinus -post surgery-
I would advise you to take Second Surgeon's opinion while you treat with medicines.Do it under guidance of Surgeon,who could give you option of

-Chemical cauterisation-a painful and time consuming process,Which I would advise only if you don't want to
- opt for -Radical Surgical Excision -of the Coccyx with Excision of the Pilonidal Sinus with its fistulous branches- by team of Surgeon as Coccyxial bony tip is the cause of recurrence most of the times,/
-which could be later on maintained with Dermatologist who would take care of the gluteal cleft,by preventive care of seborrhic dermatitis or any other cause as diabetes, to prevent recurrence of pilonidal sinus with recurring abscess.


Still I would suggest you to take Second opinion from ER Surgeon and Dermatologist, as I don't have any first hand clinical information or a photograph of this extensive health problem.

You have to take this treatment under cover from ER Surgeon and Dermatologist.

So to rule out other causes I would suggest you to consult ER Surgeon and Dermatoglogist, who would treat according to the cause found.

And act fast on the above suggestions,which helps you to plan treatment with your ER Surgeon and Dermatologist.

Hope this would resolve your query with full satisfaction.
Welcome for any further query in this regard to ME by direct question at HCM.

Write excellent review and hit thanks, to narrate your experience ,which would improve my rating for many other visitor's to HCM.

Wishing you fast recovery.
Have a good day.
Dr.Savaskar M.N.
Senior Surgical Consultant.
M.S.Genl-CVTS
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