Regular epilation alone is an acceptable treatment for symptom-free pilonidal patients
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Read the article on link.springer.com ↗Article · Oct 2023 · 1 min read
In brief
In brief
This prospective study demonstrates that regular hair removal (epilation) alone is as effective as combined surgical excision and epilation for asymptomatic pilonidal disease patients, with similar recurrence rates (12.6% vs 9.4%). The findings support a conservative-first approach in symptom-free adolescent patients, potentially avoiding unnecessary surgical intervention.
Written by the GCMD Library team from the article.
Abstract
Introduction
Patients with mild pilonidal disease often experience symptom resolution without excision. We hypothesized that treating symptom-free/asymptomatic pilonidal patients with regular epilation alone had similar recurrence rate as patients who were also treated surgically.
Method
Patient data were prospectively collected 2/2019-11/2022 at our Pilonidal Clinic. All patients received regular epilation; all patients presented before 12/2020 also underwent pit excision using trephines. Starting 1/2021, only symptomatic patients underwent pit excision; symptom-free patients at presentation received only regular epilation. Recurrence rates were statistically analyzed.
Results
255 patients (male:54.4%, female:45.6%), median age 17.3years (IQR:15.8–19.1) were followed for median 612.5days (IQR:367.5–847). 44.1% identified as Hispanic, 36.5% Caucasian, 17.1% Asian, 2.4% Black. Median symptom duration at presentation was 180.5days (IQR:44.5–542.5). 160 patients were initially treated with surgical excision and regular epilation, while 95 patients with regular epilation only. The failure rate between patients who received surgical excision initially and recurred (9.4%) and patients who received epilation only and recurred (12.6%) was similar, after controlling for sex, race, age, comorbidities, skin type, hair color, hair thickness (p > 0.05). Patients who recurred after only undergoing regular epilation all underwent surgical excision, median 100days (IQR:59.5-123.5) after initial presentation.
Conclusion
Regular epilation alone is an acceptable treatment for symptom-free pilonidal patients.