My surgeon was a bit of a character and told me "I'd rather have my head shot off than have a pilonidal sinus surgery re-packed" -I elected for surgery. Open wound after debridement I believe, to be packed with sterile gauze as it healed. My partner, bless her, did the packing, something she'd rather forget too. Nurse wasn't up for it.<p>Sitz baths in plain old salty water were a delight.<p>Get it treated folks, especially if you travel for a living like I did: it usually won't go away by itself.<p>Alas mine was familial. My son poor bugger already has signs.