Topical Lidocaine or not for laser follicle ablation in pilonidal disease: a prospective, randomized, double-blinded trial

jpedsurg.org

Laser follicle ablation is a significant component of the care in pilonidal disease, but may be uncomfortable secondary to absorption of the light energy by pigment present in the underlying skin. Multiple methods have been proposed to ameliorate the discomfort, including the pre-procedure application of topical lidocaine creams; however, little data exists as to the efficacy of the creams, which must be applied 30 to 40 minutes prior to laser treatment. We studied the efficacy of a topical local anesthetic cream for this purpose.

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Article · Oct 2025 · 1 min read

In brief

This randomized controlled trial evaluates whether topical lidocaine cream effectively reduces discomfort during laser follicle ablation for pilonidal disease. The study addresses a practical clinical question about pre-procedure analgesia, given the 30-40 minute application time required and limited existing evidence on efficacy.

Laser follicle ablation treats pilonidal disease but causes discomfort from light energy absorption by skin pigment.
Topical lidocaine creams require 30-40 minute pre-application, adding procedural time and patient inconvenience.
Limited evidence exists on topical anesthetic efficacy for laser ablation procedures in pilonidal disease management.
This RCT provides data to guide pain management protocols for outpatient pilonidal laser treatments.

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