There are few reports on recovery from pilonidal disease by conservative, non-surgical care, strict adherence to local hygiene and removal of protruding hairs from pilonidal pits.
Acute infection with abscess formation requires urgent surgical drainage and is usually followed by a complement surgical procedure after infection subsides.
An initial infection, before abscess formation, may be treated with antibiotics.

Surgery, however, is the common recommended treatment for those suffering from continuous symptomatic pilonidal disease.

There are dozens of surgical methods used worldwide for the treatment of pilonidal disease. These can be classified into two main fundamental categories:
1. Operations employing wide radical excision of the natal cleft.
2. Treatments employing minimal or no excision of tissue.