Watch Fereshteh Salimi Jazi, MD, present her presentation on "Increasing amount of hair reduction using laser correlates with lower probability of recurrence in patients with pilonidal disease."
Intended audience: Healthcare professionals and clinicians.
Hi, my name is Fersta Salimijad, thank you for the opportunity to present our study titled increasing amount of hair reduction using laser correlates with a lower probability of recurrence in patients with pilol disease. We don't have any disclosure. As we know the presence of hair in the gluteal crease is the most important predisposing risk factor for polol disease. In this study, we investigated the number of laser sessions required to achieve certain amount of hair reduction. We hypothesize that the more hair reduction could correlate with a lower chance of polol disease recurrence. This is a retrospective observational study on all patients who presented from June 2019 to April 2022. Patients were categorized into three groups based on their Fitz Patrick skin types. Also, they were categorized into three groups based on their hair thickness and two groups based on their hair color. Each patient underwent laser ablation every 6 to8 weeks with the goal of achieving more than 90% hair reduction. At each laser session, gluteal clift was shaved, photos were taken right before shaving and examined to determine if the patients were achieved 20, 50, 75 or 90% hair reduction. Different groups were compared. Multivariant T test and linear regression model were used for data analysis. A total of 198 patients were included. 102 patients were male and 96 patients were female. As you see in this table, majority of patients had dark colored and medium thickness hair. Also majority had skin types three and four. The mean age at the time of first laser session was 18 years. Median follow-up time was 217 days. Regardless of patient's hair and skin characteristics, a linear relation was observed between number of laser sessions and amount of hair reduction. On average, 2.6 laser sessions required to reach 20% hair reduction, 4.3 sessions required to reach 50% hair reduction, 6.6 sessions required to reach 75% and 7.8 sessions were required to reach 90% hair reduction. Further analysis showed that patients with skin types 1 and two required less average laser sessions to reach the same percentage of hair reduction compared to the other two skin type groups. Also, thicker hair and dark colored hair were associated with higher average laser sessions. In our patient cohort, 44 patients underwent incision and drainage at the time of presentation, while 132 patients underwent trefination procedure. 22 patients did not undergo any surgical intervention under out care. The recurrence rate was 6%. None of the patients with more than 75% hair reduction experienced the recurrence. After controlling for other co-founding factors, dark hair and skin type five and six were associated with higher recurrence rate. The mean number of sessions after which recurrence occurred was 3.2 sessions. Data analysis showed that the probability of recurrence decreases with increase in percentage of hair reduction. In our patient cohort, the probability of recurrence after 20%, 50% and 75% hair reduction was decreased by 50%, 78% and 100% respectively. Our review showed that patients with dark colored and thick hair require more laser sessions to achieve a certain percentage of hair reduction, and those with dark hair and skin type five and six were more likely to experience polol disease recurrence. We demonstrated that increasing percentage of hair reduction was correlated with a decrease in polol disease recurrence. Since in our patient cohort, no recurrence occurred after achieving 75% hair reduction, we may conclude that this could be a treatment target for polol disease patients. Thank you.
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