KidsMD Health Topics

Pilonidal Sinus

  • Overview

    Pilonidal sinusA pilonidal sinus is a dimple in the skin in the crease of your child's buttocks.

    • This may be noted at birth as a depression or hairy dimple and be present for many years without any symptoms.
    • A pilonidal sinus may also occur due to a blockage in the hair follicles, often associated with an ingrown hair.
    • In both situations, hair acts as a foreign body, which may produce an infection. The infection may spread into the tissues of your child's buttocks and produce an abscess (collection of pus under the skin) at a site several inches away from the sinus.

    Kid-friendly care

    Boston Children's Hospital provides special surgical care in a family-centered environment that children need. Our caring, compassionate and child-friendly surgical team includes expert pediatric surgeons, anesthesiologists, nurses and assistive personnel, all extensively trained and experienced in pediatric surgical care.

    Boston Children's Hospital 
    300 Longwood Avenue
    Fegan Building 3rd Floor
    Boston MA 02115

  • In-Depth

    Pilonidal sinusWhat are the symptoms of a pilonidal sinus?

    • Persistent pain in the tailbone area accompanied by an abscess within the crease of the buttock. If the abscess ruptures, drainage or pus may also be present.
    • Chronic infection may develop if the infection has spread beyond the site of the sinus and is poorly drained.
    • Symptoms of chronic infection include bloodstains or cloudy drainage on your child's underclothes.
  • Tests

    How is a pilonidal sinus diagnosed?
    Your child's doctor will be able to diagnose a pilonidal sinus on your child in a physical exam. The physician will also be able to tell if there's any sort of infection associated with the sinus.

  • How is a pilonidal sinus treated?

    • Your child's doctor will open and drain the abscess to allow it to heal.
    • After the abscess has healed, surgery may need to be done that involves taking out the underlying fistula tract and the chronically infected tissues.
      • If the involvement is extensive, the wound is left open to heal.
      • If there's not a lot of tissue involved, the wound may be closed. When successful, this allows for more rapid healing and less discomfort—unfortunately it's also associated with a higher incidence of recurrent infection.

    What happens after surgery?

    • If the wound is left open to heal, you'll need to pack the wound one or two times a day after your child has showered or soaked in the tub.
    • Antibiotics may be prescribed to treat any infection.
    • Your child shouldn't do strenuous activity, exercise or lifting for four to six weeks.
    • Your child shouldn't do sit for extended periods of time.
    • Your child will probably have some pain. Give pain medicine as prescribed and instructed by your doctor and nurse.
    • You should schedule an appointment with your surgeon in his office for one to two weeks after going home.

    What if there are complications after the surgery?

    Call your doctor if your child develops:

    • a fever above 101.5 F
    • any redness around the incision
    • any drainage
    • worsening pain
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