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

Abstract

INTRODUCTIONPilonidal sinus disease (PD) is a chronic debilitating illness involving the sacrococcygeal area. It commonly affects economically productive age groups and carries a significant effect on social activities and quality of life. Despite the availability of many surgical options, recurrence continues to be a major issue. Laser depilation therapy (LDT) has been proposed as an adjunct to surgery in PD and shown promising results in minimising recurrence. We present our initial experience in adjuvant LDT in patients with PD in a district general hospital.METHODSProspectively maintained database of patients with PD who have had Laser-induced hair removal after surgical therapy from 01/06/2013 to 01/06/2018 were analysed. Patients were offered a minimum of two sessions of LDT and all Fitzpatrick skin types were enrolled. Follow up data were available until 01/06/2019. Persistent symptoms of PD after 1 year from the date of last surgical intervention were recognised as recurrent disease. Data are presented as median.RESULTSSixty-seven (67) patients underwent LDT, although 60 patients were eligible for final analysis. Fifty-seven of them were males (57:3) and the median age was 23 (16-46) years. 15% of patients were smokers and 13% had their BMI over 30. The majority (64%) of patients received 6 cycles of LDT. There were no complications related to Laser treatments. Overall, our recurrence rate after LDT was 13% at a median follow up of 172 weeks. A subset of patients who had Laser hair removal after EPSiT demonstrated the lowest recurrence rate of 6%. CONCLUSIONLDT is a safe and effective adjunct to surgery in reducing the recurrence of PD. Patients after EPSiT may have greater benefits of LDT. High quality randomised control trials are required to prove its efficacy and safety further