Successful Treatment of Recurrent Pilonidal Sinus with Laser Epilation

Abstract

BACKGROUND. Pilonidal disease is a chronic disease of the natal cleft. Recurrent follicular infection is the causative factor. Surgical treatment has a significant failure rate, and recurrence is common. Laser removal of hair in the natal cleft could be an alternative to surgery. OBJECTIVE. To determine the effectiveness of laser hair removal in the natal cleft on pilonidal disease. METHODS. Six young men with recurrent pilonidal disease were treated with laser epilation in our clinic from 2000 to 2003. Most patients had a history of one or more surgical treatments in the area, and all patients had suffered recurrent folliculitis for years. An alexandrite laser was mostly used, although, occasionally, an intense pulsed light device was used. The number of epilation treatments ranged from 3 to 11, performed at 6-to 8-week intervals. RESULTS. All patients experienced progressive resolution of the folliculitis with the laser epilation treatments. No more surgical treatments have been needed. The treatments were simple and quick, and there were no complications. CONCLUSION. Laser epilation of the natal cleft should be considered a first choice treatment for recurrent pilonidal disease. Preventive laser epilation of the natal cleft in patients with recurrent folliculitis could avoid future surgery.

Crystallized Phenol in Nonoperative Treatment of Previously Operated, Recurrent Pilonidal Disease

“…Nonoperative methods used for pilonidal disease have included natal cleft shaving and improved perineal hygiene, 13 laser epilation, 14 and intense pulsed light, 15 in addition to phenol application, 5 but only a few case series have dealt with nonoperative methods in recurrent disease. 14,16 The results of our previous study 7 encouraged us to further investigate the efficacy of crystallized phenol in recurrent pilonidal disease. Our study included 36 patients with recurrent pilonidal sinus after previous surgery.…”

Control of hair growth using long-pulsed alexandrite laser is an efficient and cost effective therapy for patients suffering from recurrent pilonidal disease

“…The secondary role played by the hair in pilonidal sinus was explained by Bascom et al [6]; hairs in the distorted follicles are pushed down through the floor of the follicle, which is already distended with keratin [7], which then join other follicle content in creating inflammation of Outcomes after treatment Completion of therapy, currently on review 6 Therapy incomplete, currently still receiving therapy 10 Required surgical treatment, given early recurrence of disease 1 Required conservative management of recurrent disease 2 a Comparison of median duration of therapy and disease-free interval was found to be statistically significant (p < 0.01, Wilcoxon signed rank test) Fig. 1 Variation of hair density (cm 2 )-before and after laser therapy subcutaneous tissue, thus leading to formation of a pilonidal abscesses [8]. Hairs that originate elsewhere on the body do not penetrate intact skin but enter through an existing hole in the skin of the cleft [5,9], which had formed by the perforating folliculitis.…”

Therapeutic approaches to patients with pilonidal sinus based on specific clinical characteristics

“…The optimal treatment should include a method that implies low costs, fast recovery with minimal time off from work (the majority of the patients are young active people), low complication rates, low recurrence and satisfactory cosmetic result. Conservative treatment satisfies all these requirements and should be the first line of treatment for patients with pilonidal disease [5][6][7][8]. Although conservative treatment requires a careful follow-up, it is successful in high percentage of patients [1,2,7,8].…”

“…Conservative treatment satisfies all these requirements and should be the first line of treatment for patients with pilonidal disease [5][6][7][8]. Although conservative treatment requires a careful follow-up, it is successful in high percentage of patients [1,2,7,8]. If signs of abscess or infection are present, laying open of the sinus tract and antibiotic treatment are required.…”

“…If excision surgery is required, controversies exist about of the optimal reconstruction method. Many prospective randomised trials have been performed with conflicting results [8][9][10][11][12][13][14][15].…”