Laser hair depilation therapy for pilonidal sinus disease: a 5-year, retrospective experience in a university teaching hospital in the UK, 2017-2023.

Abstract

Background: Pilonidal sinus disease (PSD) is a chronic, debilitating condition predominantly affecting young men. Laser hair depilation is an established adjunct to surgical treatment for PSD. It can lead to reduced rates of recurrence and postsurgical interventions.

Objectives: To assess the outcome of laser hair depilation therapy on disease progression in patients with PSD at the Birmingham Skin Regional Laser Centre.

Methods: Patient demographics, PSD clinical stage, laser type, number of laser sessions, surgical intervention and treatment outcomes were extracted from electronic medical records of patients (n = 97) referred for laser hair depilation between 2017 and 2023. Statistical analysis was performed using Microsoft Excel and R. Treatment outcomes were categorized as improvement (healed, improved) or no improvement of underlying PSD. Disease severity was classified using the method of Guner et al. (BMC Surg 2016; 16:18).

Results: Most patients affected were male (77%). The median age was 22 years (interquartile range 20-28). The median number of laser hair removal sessions was 8 (interquartile range 5.5-10). The number of laser hair removal sessions was the only predictive factor for symptom resolution (P < 0.001). Neither surgical intervention nor the type of surgery (incision, excision, modified flap, or endoscopic surgical intervention) showed a significant association with improvement in PSD (P = 0.47 and P = 0.65, respectively). In the subgroup of patients who did not undergo surgery (n = 32, 33%), 25 patients (78%) had improvement or healing in their PSD. There were no statistically significant associations between age, type of laser, disease severity and benefit from laser hair removal. No complications were reported and there was only one case of recurrence.

Conclusions: Laser hair depilation is a safe and effective postoperative adjunct treatment for treating sacrococcygeal PSD. For early-stage disease it may offer curative treatment.