If there is infection, treatment is generally by incision and drainage just off the midline. Following five simple rules has been known to prevent recurring inflammations for some people and avoid the surgery: 1. Avoiding chairs and car seats that put pressure on coccyx; 2. Being of normal weight, preferably with low BMI; 3. Keeping the area clean; 4. Keeping the area dry by wearing exclusively cotton garments; 5. Keeping the area completely hair free, for example by regularly using an IPL hair removal device. The evidence for elective treatment of<unk>  sinus<unk>  is poor. The most commonly performed surgery is for the<unk>  sinus complex to be surgically excised with the wound often left open to heal. Post-surgical wound packing may be necessary, and packing typically must be replaced daily for 4 to 8 weeks. In some cases, two years may be required for complete granulation to occur. Sometimes the cyst is resolved via surgical marsupialization. Surgeons can also excise the sinus and repair with a reconstructive flap technique, such as a "cleft lift" procedure or Z-plasty, usually done under general anesthetic. This approach is especially useful for complicated or recurring<unk> , leaves little scar tissue and flattens the region between the buttocks, reducing the risk of recurrence. This approach typically results in a more rapid recovery than the traditional surgery, however there are fewer surgeons trained in the cleft lift procedure and it consequently may not be as accessible to patients, depending on their location. Meta-analysis shows recurrence rates were lower in open healing than with primary closure (RR 0.60, 95% CI 0.42 to 0.87), at the expense of healing time.<unk>  cysts can recur, and do so more frequently if the surgical wound is sutured in the midline, as opposed to away from the midline, which obliterates the natal cleft and removes the focus of shearing stress. An incision lateral to the intergluteal cleft is therefore preferred, especially given the poor healing of midline incisions in this region. Minimally invasive techniques with no wound and rapid return to full activities have been reported but await double blind randomised trials. Nevertheless, outcomes on a number of patients are excellent, especially when coupling the sound principles of John Bascom to the employment of biopsy punches technique developed by Dr. Basso in Rome (Italy), see miniatures below. Another technique is to treat<unk>  sinus with fibrin glue. This technique is of unclear benefit as of 2017 due to insufficient research. The evidence for any treatment is of low quality, and care must be taken not to over interpret any study in this field. File:Pilonidal Cyst.Excised<unk>  cyst File:Trephine surgery 1.Trephine/biopsy punch minimally invasive surgery for<unk>  (1) File:Trephine surgery 2.Trephine/biopsy punch minimally invasive surgery for<unk>  (2) File:Pilonidal cyst 2 days after surgery.Pilonidal cyst two days after traditional closed surgery. File:Pilonidal cyst and fistula.alt=Anatomy of<unk>  removed after trephine or biopsy punch surgery:<unk>  fistula (top) and<unk>  cyst (bottom)
Pilonidal disease
Hidradenitis suppurativa
Cystitis glandularis
Folliculitis
Vulvar vestibulitis
Anorectal abscess
Haemolacria
Urachal cancer