Dr. Samhitha Reddy
Consultant Proctologist & Laparoscopic Surgeon
MBBS, MS, FMAS, FISCP, DMAS
- 8 Yrs
- ASCRS Member
Proctology · Pilonidal Disease
Pilonidal Sinus Treatment in Hyderabad: Laser Surgery at Lux Hospitals
A pilonidal sinus is a small tunnel under the skin at the top of the buttock cleft, formed when loose hair works its way in and the body treats it as a foreign body. It flares, discharges, settles, and flares again.
Traditional excision leaves a large open wound that can take months to heal. Our surgeons at Lux Hospitals, HITEC CITY use laser and minimally invasive techniques instead, so the tract is destroyed through a few millimetres of skin and you are back on your feet in days.
- Laser & Minimally Invasive
- Back to Work in Days
- Low Recurrence
What is a Pilonidal Sinus?
A pilonidal sinus is a small tunnel or cavity in the skin, almost always at the base of the spine in the natal cleft. It forms when loose hair and skin debris get driven into the skin, where the body walls them off as an infected pocket.
On the surface you may see nothing more than one or two tiny pits in the midline of the cleft. Beneath them sits a cavity that fills with hair, debris and pus, and which drains intermittently through those pits.
It is most common in young adults between fifteen and thirty, in men more than women, and in people who sit for long stretches: drivers, desk workers and students. Excess body hair, sweating and friction all make it more likely. It is not caused by poor hygiene, though hygiene helps once you have one.
Causes of Pilonidal Sinus
The exact trigger is not always clear, but the mechanism is: hair gets pushed into the skin, and the skin reacts to it.
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Ingrown hairs
Loose hairs are driven point-first into the skin of the cleft, where the body walls them off as a foreign body.
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Prolonged sitting
Long hours seated (driving, desk work, study) press the cleft together and work hair inward. Hence its old name, "jeep disease".
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Excess body hair
More hair in the area means more loose hair available to be driven in, which is why it is commoner in men.
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Sweating and moisture
A warm, damp cleft softens the skin and lets hair penetrate more easily, and it suits the bacteria that follow.
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Friction and irritation
Rubbing from tight clothing or repeated movement breaks the skin surface and opens the way in.
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A deep natal cleft
A deeper cleft traps more hair and stays damper, which is why some people get this and others never do.
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Genetic predisposition
A family history is common. Hair type, cleft depth and skin characteristics are all inherited.
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Being overweight
Extra weight deepens the cleft and increases both friction and moisture in it.
None of this is about cleanliness. A pilonidal sinus is a mechanical problem with hair and a skin fold, not a hygiene failure.
Symptoms of a Pilonidal Sinus
A pilonidal sinus swings between two states: quiet and discharging, or acutely infected and extremely painful.
Chronic, low-grade symptoms
- One or more small pits or dimples in the midline above the tailbone
- Intermittent discharge of pus or blood, often staining clothing
- A foul smell from the discharge
- Mild tenderness or a lump felt under the skin
- Discomfort when sitting for long periods or when driving
Acute infection or abscess
- Severe, throbbing pain near the tailbone
- A hot, red, swollen lump beside the cleft
- Skin that is tense and painful to touch
- Fever and feeling generally unwell
- Sudden relief as the abscess bursts and drains
The quiet phase is not the sinus healing: it is the sinus waiting. Nearly every pilonidal sinus that is left alone comes back to the acute phase eventually.
How a Pilonidal Sinus is Diagnosed
Diagnosis is clinical and quick: the midline pits are close to unmistakable. Imaging is reserved for complicated or recurrent disease.
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Visual examination
The characteristic pits in the midline of the natal cleft are usually enough to make the diagnosis on sight.
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Palpation
Feeling the area maps the extent of the underlying cavity and any side tracts running off from it.
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Assessing for abscess
A hot, fluctuant swelling means an active abscess, which needs draining first: before any definitive surgery.
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Ultrasound
Maps the depth and branching of the cavity in complex or recurrent cases, and guides how much tissue must be treated.
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MRI
Occasionally used for extensive or repeatedly recurrent disease, to show the full extent before planning a flap procedure.
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Ruling out look-alikes
An anal fistula, a sebaceous cyst or hidradenitis can look similar. Position relative to the anus is what separates them.
Most patients are diagnosed at the first consultation and can be given a treatment plan the same day.
Treatment Options for Pilonidal Sinus
An acute abscess is drained first, whatever the eventual plan. Definitive treatment then aims to destroy the tract with as small a wound as possible: a large open excision heals slowly and is what gives this condition its reputation.
Non-surgical
Conservative and first-aid measures
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Incision and drainage
For an acute abscess, a small cut releases the pus and relieves the pain immediately. It settles the infection but does not cure the sinus.
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Antibiotics
Control spreading infection and cellulitis around the sinus. They are supportive treatment, not a cure for the tract.
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Hair removal
Laser hair reduction over the cleft removes the raw material the sinus feeds on, and materially lowers recurrence after surgery.
Surgical
Surgical treatment for pilonidal sinus
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Laser pilonidoplasty (SiLaC)
A laser fibre is passed into the tract and withdrawn, destroying its lining so the cavity collapses and seals. Only the tiny pits are opened, so there is no large wound and patients are usually back to daily activity within days.
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Endoscopic treatment (EPSiT)
A fine endoscope goes into the cavity so the surgeon can see and clear every hair, side branch and pocket under direct vision before ablating the lining.
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Pit picking (Bascom procedure)
The midline pits are excised as tiny cores and the cavity is drained through a small lateral incision, away from the cleft where wounds heal badly.
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Excision with flap closure
For extensive or repeatedly recurrent disease, the sinus is excised and closed with a Limberg or Karydakis flap that flattens the cleft: the most durable option, and the one with the lowest long-term recurrence.
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Open excision
The traditional operation: the tract is excised and the wound left open to heal by itself. Very effective, but the wound takes six to twelve weeks of dressings, so it is now reserved for the most severe disease.
The best treatment depends on how extensive the disease is. For most first presentations seen here, laser or endoscopic treatment is the first offer, because it cures the sinus without the wound that people dread.
What Laser Pilonidal Surgery Involves
A thirty to forty minute day-care procedure, done through openings a few millimetres wide. No large wound, no packing, and no months of dressings.
SiLaC: laser pilonidoplasty
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Pre-operative assessment
Routine bloods, an ultrasound where the disease is extensive, and a six-hour fasting window. Any active abscess is drained and settled first.
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Anaesthesia
A short spinal or general anaesthetic, with you positioned face down. The procedure itself is painless.
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Clearing the cavity
The pits are opened as tiny cores and the cavity is curetted to remove every trapped hair, granulation tissue and pocket of debris. Hair left behind is the commonest reason a sinus recurs.
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Laser ablation
A radial laser fibre is passed into the cavity and drawn back at a controlled rate, delivering energy in every direction so the lining is destroyed and the walls collapse together.
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Checking side branches
Each side tract is treated in turn. An untreated branch is a sinus that will discharge again within months.
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Recovery & discharge
Two to four hours in day care, then home the same evening with antibiotics, painkillers and simple dressing instructions.
Because the cleft is never opened up, there is no cavity to pack and no wound to dress for weeks, which is the single biggest difference from the traditional operation.
Why Choose Lux Hospitals for Pilonidal Sinus Surgery in Hyderabad?
Pilonidal disease is judged on the wound it leaves as much as on the cure. Here is why patients trust us:
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Expert team
Surgeons with extensive experience of complex and recurrent pilonidal disease, not just first presentations.
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Advanced technology
Laser and endoscopic treatment as the default, so the cure does not cost you months of dressings.
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Comprehensive care
From the first consultation through to post-treatment follow-up, with one team throughout.
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Convenient location
Our hospital is in HITEC CITY, near IKEA: easily reachable from across Hyderabad.
Recovery & Aftercare
This is where minimally invasive surgery earns its keep. Laser recovery is measured in days; a traditional open wound is measured in months.
- Day 0
Home the same evening. Mild soreness over the tailbone, controlled with oral painkillers. Lie on your side rather than your back.
- Days 1–3
Walking and light activity encouraged. Sitting is comfortable with a cushion. Desk work is realistic from day two or three.
- Week 1
Some serous discharge from the treated pits is normal and settles. First follow-up review at the end of the week.
- Weeks 2–4
The pits close and the cavity seals. Driving, gym and normal routine resume. Laser hair reduction usually starts around now.
- Weeks 6–8
Final review confirming complete healing. Hair-removal sessions continue as the long-term prevention.
Aftercare
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Keep the area hair-free
The single most effective thing you can do. Laser hair reduction over the cleft is what stops the sinus re-forming.
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Keep it clean and dry
Wash daily, pat thoroughly dry, and change dressings as instructed. A damp cleft is what let the hair in originally.
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Break up long sitting
Stand and walk every thirty to forty minutes for the first few weeks, and use a cushion when you must sit.
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Avoid heavy strain early
No heavy lifting or intense exercise for two to three weeks, so the healing cavity is not pulled open.
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When to call us
Fever, increasing pain and swelling, or discharge that restarts after it had stopped: the signs of a recurrence or an abscess.
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Keep every follow-up
Pilonidal disease recurs quietly. The reviews are what catch it while it is still a pit rather than an abscess.
Recurrence is the honest weakness of every pilonidal operation, and it is driven almost entirely by hair returning to the cleft. Surgery clears what is there; hair removal is what stops the next one.
When Do You Need Pilonidal Sinus Surgery?
Surgery is advised when any of the following apply.
- Recurrent infections or repeated abscess formation.
- Persistent pain despite hygiene measures and home care.
- Ongoing discharge of pus or blood from the sinus.
- Symptoms that interfere with sitting, driving or work.
Cost of Pilonidal Sinus Surgery in Hyderabad
Cost tracks the extent of the disease and the technique used. These are the ranges our patients fall into.
| Procedure | Estimated Cost |
|---|---|
| Incision & drainage of abscess Emergency procedure, usually day care | ₹12,000 – ₹25,000 |
| Pit picking (Bascom) Day care, same-day discharge | ₹30,000 – ₹50,000 |
| Laser pilonidoplasty (SiLaC) Day care, same-day discharge | ₹50,000 – ₹85,000 |
| Endoscopic treatment (EPSiT) Day care or one night’s stay | ₹65,000 – ₹1,00,000 |
| Excision with flap closure One to two nights’ stay | ₹70,000 – ₹1,10,000 |
What changes the estimate
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Extent of the sinus
A single midline pit and a branched cavity with several side tracts are different operations with different theatre times.
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First case or recurrent
Recurrent disease after previous surgery is scarred and harder to clear, and more often needs a flap.
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Laser hair reduction
Sessions over the cleft are costed separately and are strongly advised after surgery to prevent recurrence.
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Room category
A shared ward, a twin-sharing room or a private suite: the largest single swing in most estimates.
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Insurance & TPA cover
We are empanelled with most major insurers, and our team files the pre-authorisation for you.
Every figure above is an indicative range, not a quote. After your consultation you are given a written, fixed-cost estimate, and that is the number you pay, with no additions once treatment begins.
Benefits of Pilonidal Sinus Treatment at Lux Hospitals
What patients treated here can expect:
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Days, not months
Minimally invasive surgery with no large wound to dress.
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Minimal pain
No packing and no open cavity, so recovery is genuinely comfortable.
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Low recurrence
Every side branch cleared, with hair removal to prevent the next one.
Other Proctology Treatments
Our Surgeons
Pilonidal Sinus Specialists at Lux Hospitals
The proctologists and colorectal surgeons who treat pilonidal disease at our HITEC CITY hospital.
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Dr. Samhitha Reddy
Consultant Proctologist & Laparoscopic Surgeon
MBBS, MS, FMAS, FISCP, DMAS
8 years experience
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Dr. Abhishek Katha
Consultant General & Advanced Laparoscopic Surgeon
MBBS, MS, FMAS
17 years experience
Testimonials
What Patients Say About Their Treatment
Reviews from patients treated for pilonidal sinus, piles and fistulas at Lux Hospitals, Hyderabad.
From the Blog
Latest Health Articles by Lux
Written by Dr. Samhitha Reddy on pilonidal disease, piles, fistulas and colorectal health.
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Got Questions?
Frequently Asked Questions
Common questions about pilonidal sinus, its treatment, and what surgery costs at Lux Hospitals.
What is the best treatment for pilonidal sinus?
The best treatment depends on the severity of the condition. Minimally invasive procedures such as laser pilonidoplasty offer faster healing and much less discomfort than traditional excision, and are the first choice for most patients. Extensive or repeatedly recurrent disease may still be best served by a flap procedure.
Is laser treatment effective for pilonidal sinus?
Yes. Laser treatment is highly effective, with minimal pain, a low recurrence rate and much quicker recovery than open surgery. Its success depends on clearing every hair and side branch from the cavity before the laser is applied.
Can a pilonidal sinus heal by itself?
A pilonidal sinus may settle temporarily with hygiene and care, but it usually recurs. The tract remains under the skin even when it is not discharging, so in most cases surgery is needed for complete healing.
Is pilonidal sinus caused by poor hygiene?
No. It is a mechanical problem: loose hair being driven into the skin of a deep, warm skin fold. Hygiene helps once you have one, but it is not the cause, and neither is anything you did wrong.
How long is the recovery after pilonidal sinus surgery?
Recovery varies with the procedure. After laser or endoscopic surgery most patients return to normal activities within a few days and are fully healed at six to eight weeks. Traditional open excision leaves a wound that needs dressings for six to twelve weeks.
Will it come back after surgery?
Recurrence is possible with every technique, because the underlying cause (hair in the cleft) does not go away with the operation. Keeping the area hair-free with laser hair reduction after surgery is the single most effective way to prevent it.
What is the cost of laser treatment for pilonidal sinus?
Laser pilonidoplasty at Lux Hospitals ranges from about ₹50,000 to ₹85,000 depending on the extent of the disease and the room category. A written, fixed-cost estimate is shared with you after your consultation and before treatment begins.
How can I book an appointment for pilonidal sinus surgery at Lux Hospitals?
You can book an appointment by calling us, messaging us on WhatsApp, emailing care@luxhospitals.com, or walking into Lux Hospitals, HITEC CITY.
Still have questions? Call us at 079 6908 4422
Still have questions? Message us on WhatsApp at 079 6908 4444
Book Your Pilonidal Sinus Consultation in Hyderabad
Laser and minimally invasive pilonidal surgery without the months of dressings, and a fixed-cost estimate shared before treatment begins.
Plot No.116, Lumbini Avenue, HITEC CITY, Near IKEA, Hyderabad – 500032