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Pilonidal is an abscess, usually found in the natal cleft, most frequently caused when a ruptured hair follicle beneath the skin becomes infected forming an abscess (pilonidal cyst) filled with hair, keratin and debris which can develop into a sinus tract (sacrococcygeal fistula) (Pilonidal Support Alliance [PSA], 2011; Harris et al, 2012) (Figure 1).