Pilonidal sinus - management in the primary care setting.

BACKGROUND: Postanal pilonidal sinus is a skin condition in the midline of the natal cleft. A primary pit forms in the midline, caused by a hair follicle that has become infected, into which loose hairs enter to create a track or abscess.

OBJECTIVE: This article explains how a pilonidal sinus develops and presents, and details methods of treatment in the primary care setting and specialist management options.

DISCUSSION: The devastation of recurrence with further pain, embarrassment, and time off work or school (in some cases for months or years), plus the prospect of more surgery is still common for patients with postanal pilonidal sinus. This can be avoided with the correct management. Surgery now has methods that produce early healing, low recurrence rates and acceptable cosmetic results.