Pilonidal Sinus


A pilonidal sinus, also referred as a pilonidal abscess, pilonidal cyst or sacrococcygeal fistula, is a small hole or tunnel in the skin, usually at the very top of the cleft between the buttocks. Dents or pits in the skin can easily become filled with bits of skin and hair, and infected with bacteria. If the dent becomes blocked, it can get bigger, eventually forming a tunnel under the skin, filled with pus. This is known as a draining sinus or abscess.


  • This condition is commonly occurs in hairy men.
  • This is an acquired condition. ‘Pilus’ = Hair and ‘nidus’ = nest.
  • When a person sits, buttocks take maximum pressure. As they rub against clothing etc. hairs break off and get collected between cleft of the buttocks. These gradually penetrate the skin or enter the openings of sweat glands, forming a sinus. Gradually more hairs are sucked into the sinus forming a bunch of hairs, so it looks like a nest of hairs, thus it is called ‘Pilonidal Sinus’.
  • As this condition is common in jeep drivers, this condition is also called ‘jeep bottom’ disease.
  • In Ayurveda, ‘Pilonidal Sinus’ is a type of ‘Naadi Vrana’.


  • Chronic or recurring sinus in the midline, between buttocks.
  • A tuft of hair projects from its opening.
  • Discharge from the sinus is blood stained, foul smelling and contains hairs.
  • Secondary openings may be found in the midline or in the buttocks and there is an indurated track connecting the openings.
  • Generally the patient is a hairy, male and 20 to 30 yrs. of age.
  • There may be pain and swelling locally.
  • Generally, it does not penetrate the bone.
  • There may be history of repeated abscess in the region, which may have resolved spontaneously or may have been incised open.


Conservative management of Pilonidal Sinus:

  • Clean the track.
  • Removing hairs from the track and a considerable area surrounding the track.
  • Avoid occupations which involve long hours of sitting e.g. driving vehicles etc.

When an abscess has been formed (acute stage):

  • Incision and drainage (I & D) has to be done.
  • The abscess cavity has to be cleaned well to remove hairs and unhealthy granulation tissue to prevent recurrence.
  • Care should be taken as in a patient of abscess.


  • Lack of cleanliness in sacral region
  • Over sweating
  • Improper sitting style
  • Twisting of hairs below skin causing infection to hair root


Pilonidal sinus treatment is a challenge for modern medical science. Antibiotics & advance surgeries can not assure the removal of pilonidal cyst & infection. In our clinic we treat pilonidal sinus only by KSHARSUTRA. We have developed different probes & techniques for pilonidal sinus. Using appropriate technique kshar sutra is inserted correctly in the pilonidal sinus. The success of the treatment depend on two things – quality of ksharsutra & its correct insertion in the pilonidal sinus. We take care of both. This herbal thread is changed after every 7 days. Duration of treatment is 4 to 8 weeks. The duration & cost of the treatment depend on the length & stage of pilonidal cyst. No recurrence , no daily dressing required , no hospitalization required , no bed rest and patient can resume his / her routine work within few hours.

Principle behind ‘Kshara Sutra Therapy’:

Cutting and healing of the track (Sinus) simultaneously.

The idea has been to preserve the actions of all the three ingredients, i.e. the proteolytic action of the latex, the hygroscopic nature and caustic action of the Kshara and the antiseptic action of Haridra (Turmeric) powder. Due to its proteolytic enzymes and hygroscopic action, the Kshara produced debridement of sluggish tissue.

How to apply Kshara Sutra in Pilonidal Sinus:

  • Patient is placed in prone position.
  • Under aseptic measures and under proper anaesthesia, track should be identifying with the help of a probe.
  • After cleaning the track, Kshara Sutra (An alkaline herbal thread) has to be passed in the track and make it fix over there.
  • As we discussed above that due to its proteolytic enzymes and hygroscopic action, the Kshara produced debridement of sluggish tissue.
  • The Kshara Sutra has power to cut and heal the sinus track simultaneously.
  • After every week, the Kshara Sutra has to be changed with the previous one.

Pathya-Apathya ( Diet and routinely activities ) :

From the day of Kshara sutra threading procedure, light diet is advised. Patient is also advised to take plenty of fluids, blend diet, green vegetables, salad and seasonal fruits. Avoid non veg , spicy and fermented food . Do not strain during defecation. Sitz bath is useful for cleaning. Take a walk at least 2 killometers per day.


Many patients wander here and there in search of any doctor or medicines to cure pilonidal sinus and often waste their time, money and energy by getting trapped in the misleading advertisements, quacks etc. Remember pilonidal sinus is curable by ksharsutra treatment. Most of the patients egnore this disease till they feel large abscess & severe pain. Advance medical surgeries & antibiotics don’t assure 100% cure at first surgery. Beware of quacks and false claims’ advertisements like those of injection treatment, herbal treatment etc. They can harm your health and can lead to complications like anal incontinence.

Pilonidal Sinus D