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 and can lead to reduced rates of recurrence, and post-surgical interventions.This study aimed to assess the outcome of laser hair depilation therapy on disease progression in pilonidal sinus disease patients 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. Statistics were performed using Microsoft Excel and R. Treatment outcomes were categorised as improvement (healed, improved) or no improvement of underlying PSG. Disease severity was classified using Guner et al.'s method. Results: Most patients affected were males (77.3%). Median age was 22 (IQR, 20 - 28). Median LHR sessions were 8 (IGR, 5.5, 10). The number of LHR sessions provided was the only predictive factor for symptom resolution (p = 1.28e-06). Neither undergoing surgical intervention nor the type of surgery (incision, excision, modified flap, or endoscopic surgical intervention) performed showed a significant association with improvement in PSD (p = 0.474, p = 0.6504). In the subgroup of patients who did not undertake surgery (n = 32, 33.0%), 25 (79.1%) patients had improvement or healing in their PSD. There was no statistically significant association between age, type of laser, disease severity, and benefit from LHR. No complications were reported and there was only one case of recurrence. Conclusion: Laser hair depilation is a safe and effective post-operative adjunct treatment for treating sacrococcygeal PSD. For early stage disease it may offer curative treatment.