Should Surgery Be Undergone For Pilonidal Abscess Sinus?

Hello, I am now a 25 year young guy. Who was diagnosed with a pilonidal abscess sinus, around 4 years ago from an irish doc who told me I needed surgical procedures to remove the dead tissues or it would never heal. It went away For a long time, soft scar tissue covered the hole. I then moved to Asia phillippines, and get it every now and then with 3-4 month between. I have a constant lower back pain even it s not there anymore. And everytime the pain get to big, I cut a hole myself to relieve the extreme pains. And have now read NOT to do so cause of possible blood poison. always wash the bottox 3 times daily to keep it clean clean. My problem now is the increasingly pain when it recurre together with fewers headaches. It feels like it is growing somehow. The doc told me this is not possible since the tissue is dead. My question is, am I forced to get a surgical procedure due to inincreasing paiN? Is the hot wheater a factor? Also Noticed a big increase in days sick, flues colds and so since I got here. Is it connected with my pilonidal abscess? Hope to get a reply since doctors here in phillippines isnt as good as back home in the west.