A pilonidal sinus (PNS) is a small hole or tunnel in the skin that may get filled with fluid or pus, leading to the formation of a cyst or abscess. It usually affects men, in the crease of the buttocks, from the bottom of the spine to the anus. A pilonidal cyst usually contains hair, dirt, and debris. It can cause severe pain, become infected, ooze pus and blood. A pilonidal sinus may also emit a foul odour.