Laser epilation is a safe and effective therapy for teenagers with pilonidal disease

Pilonidal disease (PD) is a frustrating condition because of a recurrence rate as high as 30%. Hair insertion is the essential cause of the disease. Therefore, hair removal with shaving is a part of many postoperative regimens. These methods are resource intensive and adversely impact the life-style of both patient and family. Therefore, we investigated the use of laser epilation (LE) of the intergluteal hair in adolescents with PD as a method of permanent hair removal. Methods: A retrospective review of all patients with PD who underwent LE from 2003 to 2006 at the National Naval Medical Center, Bethesda, Md, and Walter Reed Army Medical Center, Washington, DC, was performed. Laser epilation of the intergluteal hair was carried out with a 1064 nm Nd:YAG laser (Coolglide Vantage, Altus/Cutera, Brisbane, Calif) at a standard fluence (joule/square centimeter), pulse duration, and repetition rate based on skin phototype. The patients were observed for hair regrowth and recurrence. Results: Twenty-eight teenagers (17 males, 11 females; mean age, 17.2 ± 1.4 years) underwent LE. Eight patients presented with abscess and were managed by incision and drainage followed by excision and open wound management, 17 patients presented with a cyst or sinus and underwent excision and primary closure, and 3 patients with asymptomatic sinus were managed nonoperatively. Laser epilation was performed after complete wound healing or immediately in those patients with asymptomatic sinus disease. Laser epilation was well tolerated and without complication in all patients. Intergluteal hair was completely removed in all patients. Patients required an average of 5 ± 2 LE therapy sessions for hair removal. All patients underwent at least 3 LE sessions (range, 3 to 7 sessions) at 4-week intervals. One female developed a recurrence. The mean follow-up for the group was 24.2 ± 9.9 months. Conclusions: Laser epilation is a safe method to remove intergluteal hair in teenagers with PD. This technique is an effective adjunctive therapy for the treatment of PD that may reduce recurrence.