Safety and Tolerability of Laser Hair Depilation in Pilonidal Disease: A Pilot Study.

BACKGROUND

Pilonidal disease is a common and painful disorder that can be challenging to manage. Recurrent surgical treatment is often warranted and may result in significant morbidity, with reported wound complication rates as high as 30%. Laser hair depilation of the natal cleft may decrease the incidence of recurrence. The purpose of this study was to assess the safety and tolerability of laser hair depilation in adolescents with pilonidal disease.

METHODS

We performed a prospective, single arm, pilot trial of laser hair depilation to the natal cleft in 13 patients with pilonidal disease. Each patient received an outpatient laser depilation treatment every four weeks with a goal of five total treatments. Follow-up tolerability was measured after each treatment by obtaining Likert scale, patient-reported, pain scores immediately after laser treatment and every six hours post-treatment, for the first 24 hours. Consistent pain scores <4 were used as a proxy for tolerability. The primary end point was tolerability and safety, defined as pain scores consistently <4 and no deep second-degree burns during the 24-hour post-treatment period. The secondary end point was disease recurrence at one year.

RESULTS

Thirteen patients were enrolled with 12 patients completing five laser depilation treatment sessions and one patient completing only four. There was 100% tolerability of treatments with no occurrence of second-degree burns. No patient was unable to complete a treatment session because of discomfort. Significantly diminished hair growth was noted after three treatments. All 13 patients were recurrence-free at a median follow-up of 13 months post-treatment initiation.

CONCLUSIONS

Laser hair depilation is safe and well tolerated in adolescents with pilonidal disease and may be effective at decreasing pilonidal disease recurrence. A prospective randomized controlled trial is planned to determine effectiveness of laser hair depilation compared with chemical/mechanical depilation methods in preventing pilonidal disease recurrence.