Pilonidal sinus disease (PSD) is a chronic inflammatory condition of the skin and subcutaneous tissue that typically arises from hair follicles in the natal cleft of the sacrococcygeal region [1]. The aetiology is debated but theorised to be a result of either the obstruction and subsequent inflammation of hair follicles, or acquired from hair penetrating through the skin into subcutaneous tissue [1,2]. This results in infection, abscess formation, chronic discharge and pain [2]. It is a common problem affecting 26/100,000 of the general population, with an incidence of 1.1% in young adult males [1,3]. It is a troublesome disease for patients, with negative impact on quality of life, mood, employment and self-image [4]. It also results in a significant burden for the healthcare service, with high rates of recurrence and readmission following surgery [5].