Hi dear Welcome to the platform of health care magic. Pilonidal sinus is a disease which can only be treated by surgical treatment. Rest of the methods are simply just eye wash. Not necessary the sinus will recur every time. If we keep good hygiene recurrences are rare. Pilonidal sinus is formed when the hairs at the intergluteal region persistantly scratch and irritate the skin leaving a raw area. Finally this scratched raw area is infected thus start forming a sinus. Sinus is a blind end tube like structure opening out in the skin. During surgery whole of the tube (sinus) is excised completely. so only healthy tissue are left. And finally wound heals. provided you keep the hygiene maintained of that area. Hope the question is answered with your satisfaction Thanks