Laser depilation and hygiene: preventing recurrent pilonidal sinus disease

Background: Pilonidal sinus disease of the natal cleft is a painful and debilitating condition which often recurs despite multiple surgical undertakings. We describe the long pulsed alexandrite laser for hair depilation and the role of personal hygiene, which is Often overlooked when treating this disease, as an adjunct to preventing recurrent pilonidal sinus disease. Methods: A review of 14 patients who underwent laser hair depilation in the natal cleft following pilonidal sinus surgery. The majority of patients had recurrent disease and had undergone numerous surgical procedures (range 1-5, mean 2.07) All patients were given advice regarding meticulous personal hygiene at the time of consultation. Results: 12 patients received the full course of treatment (three treatments, 6-weekly) followed by 'top-up' treatments as required (mean number of treatments 3.9). None of the patients developed recurrent disease at 1-year follow up and, to date, none have required further surgery. Conclusion: Laser hair depilation is a useful adjunct in preventing the recurrence of pilonidal sinus disease and should be offered routinely to all patients. This coupled with patient education regarding personal hygiene reduces the risk of developing recurrent pilonidal sinus disease. (C) 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.