Laser depilation as adjuvant therapy in prevention of recurrence of pilonidal sinus disease: initial experience of a district general hospital in the UK

Abstract

Introduction Pilonidal disease is a chronic condition involving the sacrococcygeal area. It can have a significant impact on quality of life, social activities and occupation. Surgery is the mainstay of treatment. However, laser depilation has been proposed as an adjunct to surgery and has shown improved results in some studies. We present our experience of laser depilation in the treatment of pilonidal disease in a district general hospital setting in the UK. Materials and methods A prospectively maintained database of all consecutive patients who received laser depilation after elective surgery for pilonidal disease was analysed. Patients were offered a minimum of two sessions of laser depilation. The primary outcome measure was disease recurrence. Evidence of new symptoms or signs of pilonidal disease after one year from the latest surgical intervention was defined as recurrent disease. Data are presented as medians with interquartile ranges. Results A total of 64 patients underwent laser depilation after elective surgery between 1 June 2013 and 1 June 2018; 57 were eligible for final analysis. Sixty-five per cent of patients received six or more sessions of laser treatment. There were no short- or long-term complications related to laser depilation. Patients who had more than two sessions of laser depilation showed an improved recurrence rate. Overall, recurrence rate in our series was 12% at a median follow-up of 172 weeks. Conclusion Laser depilation is a safe and effective adjunct to surgery in minimising the recurrence of pilonidal disease. Patients with primary pilonidal disease and those who are undergoing minimally invasive surgery may also benefit from adjuvant laser depilation. Further high-quality control trials are required to assess its efficacy and safety.

Pilonidal sinus disease recurrence at a tertiary care center in Riyadh

“…Several studies have suggested that laser hair removal helps to decrease risk of disease recurrence and should be considered as an adjunct therapy to the surgical treatment to minimize the disease recurrence. 31 , 32 Pronk et al conducted a systematic review of 14 studies to evaluate the effect of hair removal methods on recurrence rate and showed a recurrence rate of 9.3% in patients treated with laser hair removal compared to no hair removal (19.7%) and razor and cream depilation (23.4%). 30 …”

Expert recommendations on supportive skin care for non‐surgical and surgical procedures

“…Furthermore, two patients in the surgery alone control group had abnormal healing or persistent sinusitis versus none who underwent a laser procedure after surgery 36 . Laser depilation was found to be a safe and effective adjunct to surgery in minimizing the recurrence of pilonidal disease 37 …”

“…36 Laser depilation was found to be a safe and effective adjunct to surgery in minimizing the recurrence of pilonidal disease. 37 Variable outcomes in laser hair removal depend on patient factors (e.g. FPT, hair colour, thickness and density, hormonal status) and the laser system used (e.g.…”

Guidelines on Photoepilation: Techniques for Intimate Body Areas

“…Previously, standard treatment was excision of all the inflamed tissue allowing the wound to heal by granulation, although this can be a very long, tedious process. More recently, treatments are becoming less invasive [17]. If a pilonidal sinus is small, then it may only require antibiotic treatment.…”