I'm currently going though the same thing (you can find my thread Pilonidal recurrance 10 years later on the general health boards)
I found my recurrance over the weekend and have no health insurance. I'm trying to do all my research before i break down and make a dr appt (esp because I'm a full time student who works two jobs)
If it is a full blown recurrance, you def need to go to the doctor. They may be able to drain it in the office under a local, but if it does not go away, a surgical proceedure may need to be done.
Good luck
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