Surgery is recommended for patients with recurrent infection or chronic and significant symptoms of pilonidal disease. Patients with mild forms of the disease may be managed non-operatively or with simple debridement procedures.

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There are many different surgical treatments for pilonidal disease. Incision and drainage of pus is needed if an abscess forms. If symptoms are persistent or recurrent, the pilonidal disease can be cut out (excised) using various methods. A skin flap technique is often used to close the wound. Poor wound healing is a common problem after surgery for pilonidal disease. Recovery times are lengthy after flap repairs. We do not recommend excision and dressing of pilonidal wounds.