Recurrent pilonidal sinus disease: Do lasers have the answer?

Abstract

Background

Pilonidal sinus disease (PSD) is a debilitating disease arising in the hair follicles of the sacrococcygeal region. We describe our 5-year experience of managing recurrent cases with laser depilation using an 800 nm diode laser (LightSheer EP, Lumenis-Yokneam, Israel).

Patients and methods

A retrospective study was undertaken from June 2003 to June 2008. A total of 15 patients who had undergone laser depilation were included. Each patient was scheduled for 3 treatments at 6-weekly intervals. Patients were followed up for 12 months and were telephoned to ascertain disease status after the period of the formal follow-up.

Results

The majority of patients underwent at least one surgical episode (range: 1–4, mean: 2.3). Seven patients had unhealed pilonidal wounds which did not respond to conservative management. Three patients did not complete their course of treatment and one suffered a recurrence after 22 months. Following laser depilation, all seven patients with chronic non-healing wounds were healed. At the end of the study period, all patients except one remained disease free (range: 6–50 months, mean: 23.6 months).

Conclusion

Recurrence of PSD can be controlled with good perineal hygiene and regular shaving of the natal cleft; however this can be difficult and awkward. Laser hair depilation is a useful adjunct to preventing recurrence and we believe it should be routinely offered to patients who have recurrent disease. The use of laser in the treatment of chronic sinus disease also appears to hasten and aid healing; however this needs further evaluation and investigation.