It is a chronic inflammation of the skin at the level of the coccyx (tailbone).It is caused by loose hairs that penetrate the skin, enlargement of the hair follicles and colonization by bacteria. It usually occurs in men than in women and is more common in obese or hirsute people. The acute inflammation is characterized by pain, swelling, fever and/or discharge. The surgeon opens the abscess, drains the fluids, and removes hair and other debris. The wound is packed with dressing so that it can heal from the inside out. A surgical removal of the cyst is necessary for recurring infected pilonidal cyst or if one or more sinus tracts are present. In most cases, the wound is closed by stiches. The patient returns to normal activity the next day avoiding daily wound changes. It can be done under local anesthesia on an outpatient basis.