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Pilonidal sinus is a painful and recurrent problem that often affects young people, especially those with excessive hair and long sitting jobs. Patients usually experience pain, swelling, pus or blood discharge from the lower back area near the tailbone. In this Part 3 of our Pilonidal Sinus Series, we discuss an important topic: can pilonidal sinus be treated with home remedies or is surgery the best option? Many patients try to manage at home with hygiene, hair removal, ointments, sitz baths, or antibiotics. These measures may give temporary relief and reduce infection for a short period, but they do not provide a permanent solution. The sinus tract remains inside and can cause repeated flare-ups.

Surgery, on the other hand, is considered the gold standard treatment for pilonidal sinus. Open excision technique, where the tract is removed and wound left open, allows healing naturally with fewer chances of recurrence, although healing takes more time. Flap techniques like Limberg flap or other rotational flaps are advanced procedures that provide better cosmetic results, faster recovery, and very low recurrence rates. For selected cases, minimally invasive techniques like phenol injection or laser surgery may also be considered.

In this video, Surgeon Dr Imtiaz Hussain explains clearly why home remedies are not a permanent cure. They may help with symptoms but cannot eliminate the sinus completely. Surgery removes the tract, prevents repeated infections, and gives patients freedom from the constant pain and discharge. That is why surgery is the best and most permanent solution for pilonidal sinus.

Every patient is different, and treatment must be customised according to the stage of disease, number of sinus openings, infection status, and patient’s overall health. Discussing options with a qualified surgeon is always necessary to choose the best technique that ensures long-term success. Patients should not delay surgery out of fear, because untreated pilonidal sinus can worsen over time.

Surgeon Dr Imtiaz Hussain (Gold Medalist)
General & Laparoscopic Surgeon
Certified Piles, Fissure & Fistula Specialist
MBBS, FCPS, FACS (USA)
Diploma Laparoscopy (Germany), CHPE (Med. Educationist)
Fellow of American College of Surgeons
Certified ATLS Trauma Course by American College of Surgeons
FACS (USA)

Dr Imtiaz Hussain has vast expertise in treating piles, fissure, fistula and perianal problems. He also performs laparoscopic gallbladder and appendix surgeries, thyroid treatment, breast cancer and benign lumps like fibroadenoma, lipomas and sebaceous cysts. His expertise also covers scrotal diseases, hernias, varicose veins, and amputations.

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