It is a small abscess or wound having single or multiple openings
pilonidal sinus
Pilonidal Sinus appears to be very strange to my patients. It is a small abscess or wound having single or multiple openings over the tailbone at the top of the cleft of the buttocks aka natal cleft. Though natal cleft is the commonest site of this disease but it can be seen at many other places of the body like axilla and finger web. Your own hair is the culprit here. In some hairy and obese individuals, hairs in the natal cleft manage to enter under the skin through a small slit in the skin. Hair being foreign substance under the skin causes pus formation and in due course of time forms an abscess, sometimes sinus.
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Pilonidal sinus is an irritating condition with recurrent swelling which emits some amount of pus and subsides. This is mostly a subcutaneous lesion, but often a sequel of tubercular spine. Your doctor, therefore, sometimes advice skiagraphy of LS spine to exclude evidence of any pathology in underlying vertebrae.
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You need to explore surgically to cure it. Medicinal management is not of much help. Since the recurrence rate is high, one should prefer minimal invasive procedures like Pilonidal Sinus Treatment with Ksharasutra or laser.