For painful lymphnodal swelling ,you have to take antibiotics and anti inflammatory
Recurrence of pilonidal cyst after surgery is common.So,it is preferable to completely excise the cyst with good margin and leave the wound open.The healthy tissue
will grow from bottom in course of time.I treat my patients the same way.I did not encounter a single recurrence.Medicines wont work in pilonidal cyst.
Anti inflammatory drugs will not alter immune system
wish you good health