Clearly, if you develop pilonidal disease, you would like to avoid surgery if possible. Surgical avoidance, however, may not be completely under your control.
For early, mild pilonidal disease with a small pit or two and occasional pain, surgery may not be inevitable if the symptoms remain mild. Avoiding sitting for long periods of time and avoiding trauma to the area may help prevent progression, but not always. Such lifestyle modifications are not always practical or possible. After all, we all need vacations that may require long plane or train rides.
When someone does develop a pilonidal abscess and requires a drainage procedure, it still isn’t inevitable that she/he will require an operation as some people can go long periods of time or forever before redeveloping a painful abscess.
More commonly, once a person does develop a symptomatic pilonidal abscess or sinus, the symptoms will remain and often progress over time. In these situations, surgery will be required for a cure.
Symptomatic pilonidal disease really doesn’t resolve without surgery. And if you’re in this category of patients, please choose your surgeon and the operation you get wisely, as a poorly planned operation can make matters worse.