Treatment of Pilonidal Disease with Laser Epilation

Abstract

Pilonidal disease is a debilitating, chronic disease of the natal cleft. It mainly involves the sacrococcygeal region and the presentation varies from asymptomatic pits to painful draining abscesses. Treatment options vary from observation to wide excision. Unfortunately, surgical treatment often results in recurrence. The etiologic agent remains in question, as does the optimal treatment. Our objective was to assess the efficacy of laser epilation as an adjunctive therapy to surgical excision of the pilonidal sinus. Eighteen men and five women were treated with laser epilation in our office from 2001 to 2004. All patients had experienced recurrent folliculitis and had undergone some form of drainage procedure or prior excision. After surgical excision of the affected area, a Vasculite™ Plus laser was used for the epilation treatments. Each session involved 9 to 12 treatments and the patients underwent an average of two sessions. All 19 of the patients that remain in follow-up report no recurrence of their folliculitis or need for further surgical procedures. During treatment, six of the men and one of the women experienced a superficial wound dehiscence. All healed with local wound care and continued laser treatments. Laser epilation is an effective adjunctive therapy for the treatment of pilonidal disease. Although not curative in and of itself, the removal of hair allows better healing and decreases the chance of recurrence by removal of a significant etiology of pilonidal disease.

Laserepilation bei Hidradenitis suppurativa/Acne inversa und Pilonidalsinus

“…Ebenso scheint der Nd:YAG-Laser tiefer in die Dermis einzudringen [54,56,62]. Neben der ästhetischen Indikation gibt es Berichte über den therapeutischen Einsatz der Laserepilation bei chronisch follikulären Erkrankungen, wie die Pseudofolliculitis barbae oder Perifolliculitis capitis abscedens et suffodiens [63 -66] notwendig sein kann, erneute Laserungen zur Aufrechterhaltung der Rezidivfreiheit durchzuführen [35,45,85,86]. Auch bei fehlender vollständiger Haarentfernung geben einige Autoren an, dass die verbleibenden Haare dünner und weicher seien, was die Fähigkeit zur Penetration in die Dermis und somit die Gefahr eines Rezidivs reduziere.…”

Pilonidal Disease

“…For that reason, laser depilation of the natal cleft has been suggested, and it has been shown to be effective. 11,12 Laser depilation has also been described as definitive nonoperative treatment of recurrent pilonidal disease. In a small series of six patients with recurrent disease, Landa and others reported resolution of folliculitis and no further operations after 3 to 11 laser treatments.…”

“…13 However, no randomized trials have been performed, and although laser therapy does seem to be an effective adjunct to surgery, it is not regarded as curative in and of itself. 12…”

The effects of a sacrococcygeal pilonidal sinus wound on activities of living: thematic analysis of participant interviews

“…Laser epilation has been found to reduce the incidence of wound recurrence and episodes of bacterial folliculitis (Benedetto & Lewis 2005, Landa et al. 2005, Schulze et al. 2006).…”