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Allen KamravaMD · MBA · FACS · FASCRS

Does laser treatment work for pilonidal cysts?

In patients with pilonidal sinus disease, does laser ablation of the sinus tract (e.g., sinus laser treatment/SiLaT), with or without adjunctive laser hair removal, improve healing time, recurrence rate, and complication rates compared with conventional surgical excision?

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Evidence review in plain language · compiled 2026-10-13 · checked 2026-10-13 · next 2026-11-13 · automated review, how it works

What the evidence says

Bottom line

The evidence on laser treatment for pilonidal cysts is mixed, and one well-conducted trial found it was linked to more cysts coming back, not fewer.

Four moderate-quality randomised trials have tested laser treatments for pilonidal sinus disease, and they do not agree with each other. One trial of 302 people found that adding laser hair removal to standard hygiene care lowered the one-year recurrence rate. Another trial of 60 people found the opposite: adding laser hair removal to flap surgery was linked to more cysts returning, not fewer. A third trial found no difference when laser ablation was added to curettage. Because well-conducted trials point in different directions, overall certainty is only moderate, and the harm finding means caution is warranted.

How certain

Moderate

4 well-conducted randomised trials address this question directly. The studies disagree with one another, so the overall certainty is lower than any single one of them.

What it shows

Signal of harm

A well-conducted study in people reported harm.

studies found
149studies found
randomised trials
11randomised trials
people studied
28,720people studied
reviews of trials
12reviews of trials
years covered
1989–2026years covered

Read this first

  • One well-conducted trial found that adding laser hair removal to flap surgery was linked to more cysts coming back within a year (20%) than flap surgery alone (4%).
  • A large study found that laser ablation of the sinus tract alone had a significantly higher rate of the cyst coming back than open flap surgery.
  • Some studies reported more pain, more infections, or more complications with laser treatment compared with other options like crystallized phenol or holmium laser.
  • Reported complications after laser treatment have generally been minor and infrequent. One study found delayed wound healing in 20.5% of patients, and another found a 10% recurrence rate, with some of those patients needing a second laser session to achieve healing. Other studies describe overall complication rates as low, though the specific types of complications (such as infection) were not always detailed.

What the research shows

  • Time to complete wound healing

    Evidence on wound healing time is mixed and mostly comes from non-randomised studies. Some found faster healing with laser than with older surgical techniques (for example, 6.5 vs 14.5 weeks comparing laser with wide excision in one study, and faster healing with laser than with crystallised phenol in another), but a systematic review of laser techniques found a lower overall primary healing rate with laser than with traditional surgery. Only one of these studies was a randomised trial, and it measured operative time and return to activity rather than total wound-healing time, so the question of whether laser speeds healing is not settled.[1,2,3,4,5]

    Insufficient evidence

  • Recurrence rate at 12 months

    This is a key outcome, and the randomised trials that measured it disagree. One trial of 302 people found that adding laser hair removal to standard hygiene care lowered recurrence at 1 year; a secondary analysis of that same trial, restricted to the 200 patients with complete 1-year follow-up, found this benefit held only for privately insured patients, not publicly insured ones. A separate, smaller trial of 60 people found that adding laser hair removal to flap surgery was linked to more cysts returning (20% vs 4%). A third trial of 80 people found that adding laser ablation to curettage made no difference to recurrence after 6 months. Because these trials disagree, and one found harm, this outcome cannot be called a clear benefit.[1,2,3,4]

    Possible harm

  • Postoperative pain scores

    Several studies, including some randomised trials, found less pain in the days after laser treatment compared with traditional surgery such as lay-open technique or flap surgery. Most of this evidence comes from small or non-randomised studies.[1,2,3,4]

    Possible improvement

  • Wound infection or complication rate

    Studies disagree with each other. Some found fewer complications with laser treatment than with surgery or phenol, while others found more infections and complications with laser. There isn't enough consistent evidence to say which is safer.[1,2,3,4,5,6]

    Insufficient evidence

  • Return to work/normal activity time

    Multiple studies, mostly retrospective, found people returned to work or normal activity sooner after laser treatment than after traditional surgery. None of these were large, well-conducted randomised trials.[1,2,3,4,5]

    Possible improvement

  • Patient satisfaction/quality of life scores

    Several studies reported higher satisfaction scores with laser treatment compared with other treatments, but satisfaction was usually measured in the short term and without randomisation in most studies.[1,2,3,4]

    Possible improvement

What it may help with

  • In several studies comparing laser treatment with other treatments, people reported less pain and a faster return to work in the days after the procedure.[1,2,3,4,5]
  • In several studies comparing laser treatment with traditional surgery, laser treatment was linked to shorter hospital stays, faster wound healing, and in some cases shorter operating time, though no single study measured all of these at once. One study found wound healing was significantly faster with laser (mean 6.5 weeks) than with wide excision (mean 14.5 weeks), with no significant difference in recurrence. Another found hospital stay was significantly shorter with laser pilonidotomy (mean 8 hours) than with other surgical techniques. A third found laser had a shorter operative time and hospital stay, and less pain, than Limberg flap surgery, with similar healing and recurrence rates. A fourth found faster wound healing and less post-operative pain with laser than with crystallized phenol treatment. These were non-randomised comparisons, so the findings are not conclusive.[1,2,3,4]

Important limitations

  • Most of the studies are small, retrospective reviews of patients who already received laser treatment, with no comparison group. This means differences in outcomes could be due to who was chosen for treatment, not the laser itself.[1,2,3,4,5]
  • Studies described as 'laser treatment' are not all testing the same thing: some use a laser to seal the sinus tract itself, others use laser only to remove hair from the area afterward, and some combine the two with surgery or other procedures. For example, one study of laser hair removal added after surgery could not separate the laser's own effect from the effect of which surgical technique was used, and another pooled pilonidal sinus disease together with unrelated skin conditions like hirsutism without reporting a result specific to pilonidal disease. This makes it hard to know, from many of these studies, which part of the treatment was responsible for the outcome.[1,2,3]
  • The four best-conducted randomised trials disagree with each other on whether laser treatment helps, makes no difference, or causes more cysts to return, which lowers confidence in any single conclusion.[1,2,3,4]
  • Many studies followed patients for only a few months to a year. Pilonidal cysts can come back years later, so short follow-up may miss recurrences that happen after the study ended.[1,2,3]

What the studies found

  • Found a benefit84 · 56%
  • Found no clear effect6 · 4%
  • Mixed or unclear55 · 37%
  • Found possible harm4 · 3%

What kind of studies

  • Retrospective53 · 36%
  • Case series41 · 28%
  • Narrative review17 · 11%
  • Randomised trial11 · 7%
  • Prospective cohort9 · 6%
  • Systematic review8 · 5%
  • Meta-analysis4 · 3%
  • Guideline3 · 2%
  • Registry1 · 1%
  • Case-control1 · 1%
  • Laboratory study1 · 1%

The studies that decided it

  • Turpin et al. 2026

    Identifying Predictors of Recurrent Pilonidal Disease in Adolescents and Young Adults: A Secondary Analysis of a Randomized Controlled Trial

    Fewer recurrences, but only if privately insuredRandomised trialModerate quality

    200 people1 y

    laser hair treatment was linked to lower odds of recurrence overall, but this benefit was only seen in privately insured patients, not publicly insured patients

    Who was studied
    adolescents and young adults aged 11 to 21 with a history of at least one episode of pilonidal disease, not currently active
    What they received
    laser hair removal added to standard treatment
    Compared with
    standard treatment alone
    Main outcome
    disease recurrence within 1 year
    Quality
    this is a secondary analysis of a randomized trial using statistical adjustment, so the insurance-based subgroup findings are less certain than the trial's main result.
    Limitations
    this is a secondary/exploratory analysis of a trial looking at predictors of recurrence, not the primary trial outcome report, and it is from a single institution.

    Taken word for word from the abstract

    • population patients 11 to 21 y of age with a history of at least 1 episode of pilonidal disease, without active disease
    • intervention laser depilation as an adjunct to standard care
    • comparator standard care alone
    • primaryOutcome disease recurrence
    • n Complete 1-y follow-up data to be included in the multivariable analysis were available for 200 patients in the trial.
    • result laser hair treatment was strongly associated with decreased odds of disease recurrence within 1 y (odds ratio [OR], 0.26 [95% confidence interval (CI), 0.12-0.58]; P = 0.001)
    • result Laser hair treatment was significantly associated with lower odds of disease recurrence in patients who were privately insured (OR, 0.29 [95% CI, 0.16-0.55], P < 0.001) but was not associated with lower disease recurrence in those who were publicly insured (OR, 1.20 [95% CI, 0.63-2.28], P = 0.58).
    • followUp 1-y follow-up data

    J Surg Res · PMID 41365098 · Read it on PubMed ↗

  • Demir et al. 2025

    Is it beneficial to add laser ablation to curettage in the treatment of pilonidal sinus disease?

    No added benefit over curettage alone.Randomised trialModerate quality

    80 people6 months

    no significant difference between groups in pain, discharge, bleeding, wound healing problems, or recurrence at 6 months

    Who was studied
    patients with pilonidal sinus disease
    What they received
    laser ablation combined with sinus curettage
    Compared with
    sinus curettage alone
    Main outcome
    postoperative complications, wound healing, and recurrence
    Quality
    it was a randomized trial but small, with no significant differences found on any outcome, limiting confidence in the findings.
    Limitations
    small sample size per group (40 each) and only non-significant trends reported

    Taken word for word from the abstract

    • n laser + curettage (L/C; n = 40) group or the curettage-only (C; n = 40) group
    • population patients diagnosed with PSD
    • intervention laser application with sinus curettage
    • comparator only sinus curettage
    • primaryOutcome postoperative complications, wound healing, and recurrence
    • result The groups had similar results for postoperative pain, discharge, bleeding, wound healing problems at 30 days, and recurrence at 6 months.
    • followUp recurrence within 6 months postoperatively

    Lasers Med Sci · PMID 40100423 · Read it on PubMed ↗

  • Alwadees et al. 2025

    Laser versus rhomboid flap for sacrococcygeal pilonidal sinus: multi-centre comparative study

    More recurrence than open surgery.RetrospectiveLow quality

    374 people3 months

    laser treatment had a significantly higher recurrence rate than the open rhomboid flap surgery

    Who was studied
    people aged 16-70 with pilonidal sinus who had never had surgery before
    What they received
    laser ablation
    Compared with
    open rhomboid flap surgery
    Main outcome
    recurrence rate after treatment
    Quality
    This was a non-randomised comparison between hospitals, so differences between patient groups could explain the results rather than the treatment itself.
    Limitations
    Not described as randomized; abstract does not report how patients were assigned to groups or control for confounding.

    Taken word for word from the abstract

    • n 190 and 184 patients were selected for the laser and open groups, respectively.
    • population Patients are included if they are diagnosed with pilonidal sinus, between the ages of 16 and 70, and have never had surgery before.
    • intervention laser ablation and open techniques
    • comparator open rhomboid flap technique
    • primaryOutcome This study aims to assess the recurrence rate after both techniques.
    • result There is a significantly higher recurrence rate in the laser group value: <0.00001.
    • followUp Patients are seen for 4 weeks or 3 months and discharged if there are no complications.

    Lasers Med Sci · PMID 39953215 · Read it on PubMed ↗

  • Muscat et al. 2024

    Preventing Pilonidal Sinus Recurrence With Laser Hair Epilation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    Fewer sinus recurrences with laser hair removal.Meta-analysisModerate quality

    size not givena minimum of one year

    significant reduction in recurrence with laser hair epilation (odds ratio 0.319, 95% CI 0.160–0.636, p=0.0001)

    Who was studied
    people with pilonidal sinus disease
    What they received
    laser hair epilation
    Compared with
    alternative approaches to prevent recurrence
    Main outcome
    rate of pilonidal sinus recurrence after at least one year
    Quality
    It pools only three randomized trials, so the result is promising but based on limited data.
    Limitations
    Only three RCTs met inclusion criteria, and the authors call for further high-quality trials to determine ideal timing and frequency of sessions.

    Taken word for word from the abstract

    • population Pilonidal sinus disease (PSD) is a common condition associated with significant morbidity and healthcare costs.
    • intervention Laser hair epilation offers a way to reduce recurrence rates
    • comparator compared to alternative approaches
    • primaryOutcome The primary outcome measure was the recurrence rate of PSD at a minimum of one year following laser hair epilation.
    • result laser hair epilation treatments offering a significant reduction in PSD recurrence rates on odds ratio analysis: 0.319 ( 0.160, 0.636), P-value = 0.0001.
    • followUp at a minimum of one year following laser hair epilation
    • limitations they recommend further high-quality trials to investigate the ideal timing and frequency of laser hair epilation sessions.

    Cureus · PMID 39036233 · Read it on PubMed ↗

  • Minneci et al. 2024

    Laser Epilation as an Adjunct to Standard Care in Reducing Pilonidal Disease Recurrence in Adolescents and Young Adults: A Randomized Clinical Trial

    Fewer recurrences with laser hair removal added.Randomised trialModerate quality

    302 people1-year follow-up

    recurrence was significantly lower with laser epilation added to standard care

    Who was studied
    adolescents and young adults aged 11 to 21 with pilonidal disease
    What they received
    laser hair removal plus standard care (hygiene and depilation)
    Compared with
    standard care alone (hygiene and depilation)
    Main outcome
    rate of pilonidal disease recurrence at 1 year
    Quality
    it was a randomized trial but many patients were lost to follow-up, especially in the laser group, which could bias the results.
    Limitations
    One-year follow-up was available for only 63.6% of the laser group and 88.7% of the standard care group, so a substantial portion of participants were lost to follow-up.

    Taken word for word from the abstract

    • n A total of 302 participants
    • population Patients aged 11 to 21 years with pilonidal disease were recruited from a single tertiary children's hospital.
    • intervention LE and standard care (improved hygiene and mechanical or chemical depilation)
    • comparator standard care alone
    • primaryOutcome The primary outcome was the rate of recurrence of pilonidal disease at 1 year.
    • result The proportion of patients who experienced a recurrence within 1 year was significantly lower in the LE treatment arm than in the standard care arm (-23.2%; 95% CI, -33.2 to -13.1; P < .001).
    • followUp 1-year follow-up
    • limitations One-year follow-up was available for 96 patients (63.6%) in the LE group and 134 (88.7%) in the standard care group.

    JAMA Surg · PMID 37938854 · Read it on PubMed ↗

  • Pronk et al. 2018

    The effect of hair removal after surgery for sacrococcygeal pilonidal sinus disease: a systematic review of the literature

    Fewer recurrences with laser hair removal.Systematic reviewLow quality

    963 people37.0 (standard error of the mean: 35.0) months

    recurrence was lower with laser hair removal (9.3%) than razor/cream depilation (23.4%) or no hair removal (19.7%)

    Who was studied
    patients who had surgery for pilonidal sinus disease near the tailbone
    What they received
    laser hair removal after surgery
    Compared with
    razor shaving/cream depilation or no hair removal after surgery
    Main outcome
    recurrence of pilonidal sinus disease
    Quality
    the included studies were mostly small, retrospective, and of limited methodological quality, so the comparison is not reliable.
    Limitations
    small sample size and limited methodological quality of the included studies

    Taken word for word from the abstract

    • n involving 963 patients
    • population patients surgically treated for SPSD
    • intervention laser hair removal
    • comparator razor shaving/cream depilation
    • comparator no hair removal after surgery for SPSD
    • primaryOutcome the effect of hair depilation on the recurrence rate
    • result The recurrence rate was 9.3% (34 out of 366 patients) in patients who had laser hair removal, 23.4% (36 out of 154 patients) in those who had razor shaving/cream depilation, and 19.7% (85 out of 431 patients) in those who had no hair removal after surgery for SPSD.
    • followUp The mean length of follow-up was 37.0 (standard error of the mean: 35.0) months.
    • limitations Due to the small sample size and limited methodological quality of the included studies, a high-quality randomized controlled trial is required.

    Tech Coloproctol · PMID 29185064 · Read it on PubMed ↗

  • Demircan et al. 2015

    The effect of laser epilation on recurrence and satisfaction in patients with sacrococcygeal pilonidal disease: a prospective randomized controlled trial

    More recurrence when laser added.Randomised trialModerate quality

    60 people1 year

    recurrence was significantly higher in the laser group (20%) than the surgery-only group (4%) at one year, with satisfaction scores differing only in the first week and month

    Who was studied
    patients having surgery for pilonidal sinus disease
    What they received
    laser hair removal added to Karydakis flap surgery
    Compared with
    Karydakis flap surgery alone
    Main outcome
    recurrence of pilonidal disease and patient satisfaction after surgery
    Quality
    it was a randomized trial but small, from a single clinic, with recurrence checked only by phone interview.
    Limitations
    small sample of 30 per group, single-center study, recurrence assessed via telephone interview rather than in-person exam

    Taken word for word from the abstract

    • n Sixty patients scheduled for pilonidal sinus surgery in our clinic between 2011 and 2012 were enrolled in this prospective randomized controlled study.
    • population patients who underwent pilonidal sinus surgery
    • intervention Two sessions of laser epilation were applied in the second group in addition to Karydakis flap reconstruction.
    • comparator Only the Karydakis flap reconstruction technique was performed in the first group.
    • primaryOutcome investigate the effects of laser epilation on patient satisfaction and recurrence in patients who underwent pilonidal sinus surgery
    • result recurrence were detected in 4% of first group and in 20% of second group. Recurrence rates were significantly higher in the second group (P=0.045).

    Int J Clin Exp Med · PMID 25932257 · Read it on PubMed ↗

All 149 studiesEvery study that answered the question, with its design, size and result.
The other 142 studiesEverything else the search returned, including anything retracted.

  • Sirkka et al. 2026

    Outpatient laser treatment of pilonidal sinus disease: A retrospective study of short-term outcomes

    Mostly healed, some recurrence.RetrospectiveLow quality

    80 people14.4 (SD = 8.3) months

    10% had persistent disease and 11% had recurrence, with short sick leave and low complication rates

    Who was studied
    patients with pilonidal sinus disease treated as outpatients
    What they received
    laser treatment (Sinus Laser-assisted Closure) under local anesthesia in an outpatient clinic
    Compared with
    none (no comparison group; outcomes assessed within this single treated group)
    Main outcome
    rates of persistent disease and recurrence after treatment
    Quality
    This is a small retrospective study with no comparison group, so it can't show whether laser works better than other treatments.
    Limitations
    Retrospective single-center design, no control group, and reliance on patients to self-report recurring symptoms.

    Taken word for word from the abstract

    • n 80 patients were treated with outpatient Sinus Laser-assisted Closure
    • population all consecutive patients with pilonidal sinus disease who underwent Sinus Laser-assisted Closure treatment in an outpatient setting under local anesthesia
    • intervention Sinus Laser-assisted Closure treatment in an outpatient setting under local anesthesia
    • comparator The aim of this study was to evaluate the short-term outcomes of outpatient laser pilonidal sinus surgery
    • primaryOutcome Persistent disease was reported by eight (10%) patients. Disease recurrence occurred in nine patients (11%).
    • result Persistent disease was reported by eight (10%) patients. Disease recurrence occurred in nine patients (11%). The mean duration of sick leave was 3.0 (SD = 4.7) days.
    • followUp The mean follow-up period was 14.4 (SD = 8.3) months

    Scand J Surg · PMID 42852833 · Read it on PubMed ↗

  • Pomper et al. 2026

    Sinus Laser-Assisted Closure Under Tumescent Local Anesthesia for Pilonidal Disease: A Pilot Study

    Feasible, low pain, no recurrenceCase seriesVery low quality

    22 people90 days

    procedure was feasible and well tolerated, with low pain scores, few minor complications, and no recurrences at 90 days

    Who was studied
    patients with pilonidal sinus disease
    What they received
    laser closure of pilonidal sinus (SiLaC) under tumescent local anesthesia
    Compared with
    none (no control group)
    Main outcome
    feasibility, pain levels, complications, and recurrence after treatment
    Quality
    This was a small pilot study with only 22 patients, no comparison group, and short follow-up, so it cannot show whether laser treatment works better than other options.
    Limitations
    Given the small sample size, absence of a control group, and limited follow-up, larger prospective comparative studies with longer follow-up are needed to validate these findings

    Taken word for word from the abstract

    • population 22 consecutive patients with PSD underwent SiLaC under TLA
    • intervention Sinus laser-assisted closure (SiLaC) is a minimally invasive option for management of pilonidal sinus disease (PSD)
    • comparator absence of a control group
    • primaryOutcome Pain was assessed preoperatively, intraoperatively, and on postoperative days 1, 2, 3, and 7 using the Visual Analog Scale (VAS; 0-10).
    • result no recurrences, wound healing disorders, or delayed complications were observed in the full evaluable cohort (0/22)
    • n 22 consecutive patients with PSD underwent SiLaC under TLA
    • followUp All 22 patients completed the 90-day follow-up

    Cureus · PMID 42830906 · Read it on PubMed ↗

  • Jhawar et al. 2026

    Laser ablation for pilonidal sinus disease

    Claims safe, quick recovery, low recurrence.Case seriesVery low quality

    size not given2026

    described as safe, minimally invasive, quick recovery, little pain and acceptable recurrence

    Who was studied
    people with pilonidal sinus disease
    What they received
    laser ablation of the sinus tract using a 1470-nm diode laser (14-step technique)
    Compared with
    none reported
    Main outcome
    overall safety, recovery, pain and recurrence after the procedure
    Quality
    This is a technique description without patient numbers, measured outcomes, or a comparison group, so it can't show whether laser treatment actually works better than other options.
    Limitations
    No patient numbers, no quantitative outcome data, and no control group are reported; claims of safety and effectiveness are not backed by measured results.

    Taken word for word from the abstract

    • intervention a standardised 14-step technique for pilonidal sinus tract ablation using a radial 1470-nm diode laser
    • comparator Laser ablation is a safe, minimally invasive, day-case procedure
    • primaryOutcome Laser ablation is a safe, minimally invasive, day-case procedure offering rapid recovery, minimal post-operative pain and acceptable recurrence rates.
    • result Laser ablation is a safe, minimally invasive, day-case procedure offering rapid recovery, minimal post-operative pain and acceptable recurrence rates.
    • population pilonidal sinus tract ablation

    J Minim Access Surg · PMID 42657982 · Read it on PubMed ↗

  • Türker Çolak et al. 2026

    Laser-assisted endoscopic treatment of pilonidal sinus disease in children: a first pediatric series

    High cure rate, low pain.RetrospectiveLow quality

    45 people32.4 ± 11.3 months

    91.1% were cured after one laser procedure, and all patients were eventually cured after a second procedure if needed

    Who was studied
    children under 18 years old with pilonidal sinus disease
    What they received
    laser-assisted endoscopic treatment of the pilonidal sinus (LEPSIT)
    Compared with
    none - all patients received the same laser procedure, no control group
    Main outcome
    successful healing of the pilonidal sinus after treatment
    Quality
    This was a retrospective case series without a comparison group, so it cannot show whether laser treatment works better than other options.
    Limitations
    Retrospective study design with no control or comparator group, limiting ability to judge effectiveness relative to other treatments.

    Taken word for word from the abstract

    • n Of the 45 patients included
    • population Clinical data of children under 18 years of age who underwent LEPSIT for PSD
    • intervention laser-assisted endoscopic pilonidal sinus treatment (LEPSIT)
    • comparator Clinical data of children under 18 years of age who underwent LEPSIT for PSD between November 2021 and July 2023 were retrospectively analyzed.
    • primaryOutcome Successful treatment was achieved in 41 patients (91.1%) after a single procedure
    • result Successful treatment was achieved in 41 patients (91.1%) after a single procedure; 4 patients (8.9%) had recurrence, all of whom achieved cure after a second LEPSIT. Improvement was ultimately achieved in all 45 patients.
    • followUp Mean follow-up was 32.4 ± 11.3 months.

    Pediatr Surg Int · PMID 42560577 · Read it on PubMed ↗

  • Murtadi et al. 2026

    The Minimally Invasive Pilonidal Protocol: Low Short-Term Recurrence after Completion in a Single-Center Retrospective Cohort Study

    Low recurrence after laser-based protocol.RetrospectiveLow quality

    297 peopleranged from 4 to 55 months

    4.0% of patients had a confirmed recurrence after finishing treatment, most were mild and resolved again with the same minimally invasive care

    Who was studied
    patients with pilonidal cyst disease who completed a minimally invasive care protocol
    What they received
    Minimally Invasive Pilonidal Protocol (MIPP) including pit-picking procedures and laser hair removal/epilation sessions
    Compared with
    no comparison group - single treatment group only
    Main outcome
    recurrence of pilonidal disease after completing the protocol
    Quality
    This was a retrospective, single-center study with no comparison group and more than half of the original patients were lost to follow-up or still in treatment, so the low recurrence rate may not reflect everyone treated.
    Limitations
    Retrospective design, no control group, 353 of 884 patients lost to follow-up and 226 still receiving care were excluded, and only 25.7% of contacted graduates who did not return responded to the follow-up survey.

    Taken word for word from the abstract

    • population patients with pilonidal disease who completed the MIPP between January 2021 and December 2024
    • intervention graduation from our Pilonidal Care Clinic's (PCC) Minimally Invasive Pilonidal Protocol (MIPP)
    • intervention two pit-picking procedures, and 5.3 laser epilations
    • comparator This retrospective single-center cohort study evaluates the recurrence rate after graduation
    • primaryOutcome Recurrence was defined as any PCC visit after graduation with pilonidal disease on examination.
    • result Of the 297 graduates, 17 patients (5.7%) returned to the PCC with recurrence concerns; however, only 12 (4.0%) showed physical evidence of recurrence
    • result Completion of the MIPP at this center is associated with a 4.0% recurrence rate within 16 months, with most recurrences mild and again resolved with minimally invasive care.
    • n leaving the study group of 297 patients who completed the protocol and graduated
    • followUp The follow-up period for these patients ranged from 4 to 55 months.

    Eur J Pediatr Surg · PMID 42457154 · Read it on PubMed ↗

  • Esposito et al. 2026

    Sinus laser-assisted closure for pilonidal sinus disease: a prospective single-center study

    High healing, low recurrence, no comparison group.Case seriesLow quality

    218 peoplemedian follow-up of 11 months (range, 3-25 months)

    Most patients healed by 45 days (98.1%), 8.7% had recurrence, 15.1% had complications (mostly minor), and satisfaction was high

    Who was studied
    young adults with pilonidal sinus disease
    What they received
    laser treatment of the sinus (SiLaC)
    Compared with
    none (single-arm study, no comparison group)
    Main outcome
    healing rate, recurrence, complications, pain and satisfaction after laser treatment
    Quality
    This was a single-group study without a comparison treatment, so it cannot show whether laser worked better than other options.
    Limitations
    Retrospective analysis of prospectively collected data, no control group, short median follow-up of 11 months

    Taken word for word from the abstract

    • population 218 consecutive patients who underwent SiLaC for PSD
    • intervention Sinus laser-assisted closure (SiLaC)
    • comparator retrospective analysis of prospectively collected data from 218 consecutive patients who underwent SiLaC for PSD
    • primaryOutcome Demographic characteristics, intraoperative parameters, postoperative complications, healing rates, and recurrence rates were examined.
    • result Healing rates at 15, 30, and 45 days were 13.8%, 80.2%, and 98.1%, respectively, with a mean healing time of 26.1±9.8 days. Recurrence was observed in 8.7% of patients after a median follow-up of 11 months
    • n 218 consecutive patients who underwent SiLaC for PSD

    Ann Coloproctol · PMID 42266118 · Read it on PubMed ↗

  • Yildirak et al. 2026

    Early postoperative outcomes of sinus laser closure versus crystallized phenol treatment for pilonidal sinus disease: a retrospective comparative study

    Less pain and faster early recovery with laser.RetrospectiveLow quality

    230 people1 month

    Laser treatment gave less pain, fewer symptoms, and better quality of life at 1 week, with most differences no longer significant by 1 month

    Who was studied
    Patients with pilonidal sinus disease treated at a tertiary center
    What they received
    Laser closure of the sinus tract (SiLaC)
    Compared with
    Crystallized phenol treatment (CPT)
    Main outcome
    Patient satisfaction, quality of life, symptom severity, pain, and return to work at 1 week and 1 month
    Quality
    This was a retrospective, non-randomized comparison, so differences between groups could be due to factors other than the treatment itself.
    Limitations
    Retrospective design; not randomized; short follow-up of only 1 month; authors call for randomized trials to confirm findings.

    Taken word for word from the abstract

    • n A total of 230 patients were analyzed (SiLaC n = 93; CPT n = 137)
    • population Patients with PSD undergoing SiLaC or CPT with scheduled 1-week and 1-month follow-up assessments were included.
    • intervention sinus laser closure (SiLaC)
    • comparator crystallized phenol treatment (CPT)
    • primaryOutcome The primary outcomes were patient satisfaction, health-related quality of life (SF-36), symptom severity (itching, burning, purulent discharge), pain intensity (Visual Analogue Scale), and time to return to work, all assessed at 1 week and 1 month postoperatively.
    • result At 1 week, itching (1 [1-1] versus 1 [1-2], p < 0.001), burning (1 [1-1] versus 1 [1-2], p = 0.001), and purulent discharge (1 [1-1] versus 1 [1-3], p < 0.001) were less frequent in the SiLaC group.
    • result At 1 month, most outcomes were comparable between groups, although purulent discharge remained higher in the CPT group (1 [1-2] versus 1 [1-1], p = 0.045).

    Tech Coloproctol · PMID 42237035 · Read it on PubMed ↗

  • Arslan et al. 2026

    Does laser treatment affect outcome in pilonidal sinus disease? Long-term multicenter retrospective analysis of pit-picking alone vs. pit-picking with laser

    Fewer complications and faster recovery, same recurrenceRetrospectiveLow quality

    306 people5 years

    recurrence rates were similar between groups, but laser group had fewer complications, faster pain relief and quicker return to work

    Who was studied
    patients who had pit-picking surgery for pilonidal sinus disease
    What they received
    pit-picking combined with laser treatment
    Compared with
    pit-picking surgery alone
    Main outcome
    recurrence rate at 5 years
    Quality
    This is a retrospective, non-randomized comparison, so differences could be due to other factors rather than the laser itself.
    Limitations
    Retrospective design, not randomized, higher cost in laser group, authors call for randomized trials

    Taken word for word from the abstract

    • population Patients who underwent pit-picking surgery for PSD between June 2017 and March 2025 were included.
    • intervention Pit-picking surgeries performed with or without LT were compared.
    • comparator Pit-picking surgeries performed with or without LT were compared.
    • primaryOutcome The primary measure was the recurrence rate at 5 years.
    • result Recurrence rates at 5 years were similar (pit-picking: 13.8%, pit-picking + LT: 12.7%, p = 0.460).
    • result The complication rate was lower in the LT group (6.1% vs. 14.7%, p = 0.012).
    • result Patients treated with LT had shorter times to pain-free sitting (median 5 vs. 7 days, p < 0.001) and return to work (3 vs. 6 days, p < 0.001).
    • n Of 306 patients, 109 (35.6%) underwent pit-picking alone, and 197 (64.4%) received pit-picking with LT.

    Tech Coloproctol · PMID 42128975 · Read it on PubMed ↗

  • de Kort et al. 2026

    Sinus laser-assisted closure (SiLaC) in pilonidal sinus disease: a multicenter cohort study

    Good symptom relief, few needed more surgery.RetrospectiveLow quality

    231 people33 months

    about 18% of primary cases and 20% of recurrent cases had treatment failure, but only 7.8% overall needed surgery other than repeat laser treatment, and quality of life was high

    Who was studied
    adults with primary or recurrent chronic pilonidal sinus disease at the tailbone
    What they received
    laser treatment of the sinus (SiLaC - sinus laser-assisted closure)
    Compared with
    no comparison group; primary disease cases compared with recurrent disease cases
    Main outcome
    treatment failure (ongoing symptoms or need for further surgery), symptoms, and quality of life at follow-up
    Quality
    this was a retrospective study without a comparison group, so it cannot show whether laser treatment works better than other options.
    Limitations
    Retrospective design, no control group, reliance on patient questionnaires for symptom and quality-of-life data.

    Taken word for word from the abstract

    • n A total of 231 patients were included
    • population Patients with primary or recurrent SPSD were included in this retrospective cohort study
    • intervention Sinus laser-assisted closure (SiLaC) is gaining popularity as a minimally invasive surgical technique to treat chronic sacrococcygeal pilonidal sinus disease
    • comparator 128 patients underwent SiLaC for primary SPSD and 103 for recurrent SPSD
    • primaryOutcome Data were collected from medical records, and a validated questionnaire was distributed to all patients at follow-up to assess symptoms, quality of life, and the need for additional surgery.
    • result Treatment failure, defined as persistent symptoms and/or the need for surgery other than SiLaC, occurred in 23 patients (18.0%) in the primary group and in 21 patients (20.4%) in the recurrent group.
    • result only 7.8% of patients in both groups requiring other surgical treatment than SiLaC
    • followUp median follow-up of 33 months (IQR 20-44)

    Tech Coloproctol · PMID 42126480 · Read it on PubMed ↗

  • Jarrin Lopez et al. 2026

    Outcomes of Pilonidal Surgery Performed in the Setting of Standard Adjunct Laser Hair Removal: A Retrospective Cohort Study

    Can't tell if laser helped.RetrospectiveLow qualityRelated question

    168 people2026

    outcomes differed more by type of surgery used than by patient factors, and the study could not separate out what effect the laser hair removal itself had

    Who was studied
    patients ages 14 to 89 who had surgery for pilonidal sinus disease
    What they received
    adjunct laser hair removal used routinely after pilonidal surgery
    Compared with
    no non-laser comparison group; compared different surgical techniques (Bascom flap vs pilocystectomy) instead
    Main outcome
    repeat procedures, surgical site infection within 30 days, and unplanned clinic visits after surgery
    Quality
    this was a retrospective study with no comparison group that skipped laser hair removal, so it cannot show whether the laser itself helped.
    Limitations
    descriptive retrospective design, no control group without laser hair removal, low event counts prevented more detailed statistical modeling

    Taken word for word from the abstract

    • population patients aged 14-89 years who underwent operative treatment of PSD with adjunctive LHR
    • intervention Adjunct laser hair removal (LHR) has been incorporated into postoperative management
    • comparator Outcomes were summarized as proportions overall and by surgical approach
    • primaryOutcome Outcomes included repeat procedures, 30-day surgical site infection (SSI), and unplanned clinic visits
    • result postoperative outcomes appeared to vary more by surgical approach than by sex or BMI. These findings are descriptive and do not estimate the independent effect of LHR
    • n Among 168 patients

    Int Wound J · PMID 42089833 · Read it on PubMed ↗

  • Saleem et al. 2026

    Surgical management of pilonidal sinus disease in pediatric population: An updated systematic review and meta-analysis

    Laser hair removal added to surgery helped.Meta-analysisLow qualityRelated question

    5,075 people2026

    Adjunctive laser epilation improved outcomes across all techniques.

    Who was studied
    children and teenagers (18 and under) with pilonidal cyst disease
    What they received
    surgical treatments for pilonidal disease, with laser hair removal used alongside some techniques
    Compared with
    different surgical techniques compared with each other (open healing, midline closure, off-midline closure, minimally invasive surgery)
    Main outcome
    cyst coming back, wound problems, and recovery time
    Quality
    It pools many different surgical studies of mixed quality and only briefly mentions laser as an add-on, without giving separate numbers for laser alone.
    Limitations
    This is a review in children only, and laser epilation is reported as an add-on to surgery across many different techniques rather than tested on its own.

    Taken word for word from the abstract

    • n 59 studies (N = 5075)
    • population patients ≤18 years with PD
    • intervention Adjunctive laser epilation improved outcomes across all techniques.
    • comparator Open healing showed the highest recurrence (20.1%) and moderate wound complication rates (16.2%)
    • primaryOutcome To compare recurrence, wound complications, and recovery outcomes across surgical techniques
    • result Adjunctive laser epilation improved outcomes across all techniques.

    J Pediatr Surg · PMID 41999968 · Read it on PubMed ↗

  • Li et al. 2026

    A systematic review and meta-analysis of sinus laser associated closure (SiLaC) versus endoscopic pilonidal sinus treatment (EPSiT) in the management of pilonidal sinus disease

    Comparable healing to endoscopic surgery.Meta-analysisLow qualityRelated question

    size not given2026

    SiLaC had shorter operative time (18.02 min vs 30.11 min) but similar cure rate (86% vs 88%), recurrence rate (11% vs 9%), complication rate (10% vs 7%), and healing time (30.08 vs 26.55 days) compared to EPSiT

    Who was studied
    patients with pilonidal sinus disease
    What they received
    laser treatment (SiLaC - sinus laser associated closure)
    Compared with
    endoscopic pilonidal sinus treatment (EPSiT)
    Main outcome
    operative time, cure rate, recurrence rate, complication rate, and wound healing time
    Quality
    This was an indirect comparison of mostly single-arm studies with very high statistical heterogeneity and no direct head-to-head trials.
    Limitations
    The authors state this is an indirect comparative analysis limited by lack of direct comparative trials, based on predominantly single-arm studies with high heterogeneity (I2 up to 99%).

    Taken word for word from the abstract

    • population Various surgical modalities exist for the management of pilonidal sinus disease (PSD)
    • intervention Sinus Laser associated Closure (SiLaC)
    • comparator endoscopic pilonidal sinus treatment (EPSiT)
    • primaryOutcome The primary outcome measures included operative time, cure rate, recurrence rate, postoperative complication rate, and total wound healing time.
    • result The mean operative time was 18.02 min (95% CI:13.42–22.62; I2 = 99.4%; P < 0.001) for SiLaC and 30.11 min (95% CI: 21.33–38.88; I² = 98.5%; P < 0.001) for EPSiT.
    • result The cure rate was 86% (95% CI: 80–91%; I2 =92%; P < 0.001) in the SiLaC and 88% (95% CI: 83–94%; I² = 87.1%; P < 0.001) in the EPSiT group.
    • result The pooled recurrence rate was 11% (95% CI: 6–15%; I2 = 90.4%; < 0.001) for SiLaC and 9% (95% CI: 5–12%; I² = 82.9%; P < 0.001) for EPSiT.
    • result The mean total healing time was 30.08 days (95% CI: 22.73–37.43%; I2 = 99.2%; P < 0.001) for SiLaC and 26.55 days (95% CI: 24.40–28.70; I² = 90.9%; P < 0.001) for EPSiT.
    • n A total of 29 studies were included.

    Langenbecks Arch Surg · PMID 41964736 · Read it on PubMed ↗

  • Matteucci et al. 2026

    The New Minimally Invasive Techniques for Pilonidal Sinus Disease Surgery: Choosing the Right Technique for the Right Patient-A Narrative Review

    Faster recovery, unclear long-term results.Narrative reviewLow quality

    size not given2026

    faster recovery and high short-term satisfaction in selected primary cases, but less proven long-term than flap surgery for complex or recurrent disease

    Who was studied
    people with pilonidal sinus disease
    What they received
    minimally invasive techniques including laser-assisted treatment
    Compared with
    off-midline flap surgery and midline primary closure
    Main outcome
    healing time, recurrence, complications and patient satisfaction
    Quality
    this is a narrative review (not systematic or meta-analysis) that itself says long-term evidence for minimally invasive techniques like laser is limited
    Limitations
    narrative (non-systematic) review methodology; abstract notes limited long-term evidence for minimally invasive approaches and calls for high-quality comparative studies

    Taken word for word from the abstract

    • population Pilonidal sinus disease (PSD) is a common condition affecting predominantly young adults
    • intervention Minimally invasive approaches, including endoscopic and laser-assisted techniques
    • comparator Off-midline flap techniques provide the most durable results in recurrent or complex disease
    • primaryOutcome with a focus on healing time, recurrence, postoperative complications and patient-reported outcomes
    • result offer faster recovery and high short-term patient satisfaction in selected primary cases, but should not be considered equivalent to flap surgery in complex or recurrent PSD due to limited long-term evidence

    Medicina (Kaunas) · PMID 41901600 · Read it on PubMed ↗

  • van Kempen et al. 2026

    Long-Term Outcomes of Sinus Laser-Assisted Closure in Primary Versus Recurrent Sacrococcygeal Pilonidal Sinus Disease: A Retrospective Cohort Study

    Laser works well first-time, worse if recurrent.RetrospectiveLow quality

    267 peoplemedian of 4.0 years (IQR: 3.6-5.0 years)

    recurrence was much more common and came back faster in recurrent disease than in primary disease, though repeat laser treatments eventually healed most patients in both groups

    Who was studied
    patients with sacrococcygeal pilonidal sinus disease, either new (primary) or returning (recurrent) cases
    What they received
    laser treatment to close the pilonidal sinus tract (SiLaC)
    Compared with
    primary disease versus recurrent disease
    Main outcome
    disease coming back (recurrence) after laser treatment
    Quality
    this is a retrospective single-center study without a comparison treatment group, so it can show patterns but not prove laser treatment is better than other options.
    Limitations
    retrospective design, single center, no comparator treatment group, some loss to follow-up (90.3% completion)

    Taken word for word from the abstract

    • n analyzed 267 consecutive patients undergoing SiLaC
    • population primary (n = 214) versus recurrent (n = 53)
    • intervention Sinus laser-assisted closure (SiLaC)
    • comparator compared long-term outcomes following SiLaC in primary versus recurrent SPSD
    • primaryOutcome The primary outcome, disease recurrence, was assessed using Kaplan-Meier analysis
    • result Recurrence rates were significantly higher in recurrent versus primary disease (RR 1.76, 95%CI: 1.30-2.40, p = 0.001), with 12-month rates of 34.8% versus 16.8% respectively.
    • result Sequential SiLaC procedures, when necessary, achieved final healing rates exceeding 90% in both groups with minimal complications (5.8%).
    • followUp median of 4.0 years (IQR: 3.6-5.0 years)

    World J Surg · PMID 41834241 · Read it on PubMed ↗

  • Tekin et al. 2026

    Localization-Based Surgical Approaches in Pilonidal Sinus Treatment: A Comparative Study of Laser Therapy and Alternative Techniques

    Fewer recurrences overall, but worse for mixed-location cysts.RetrospectiveLow quality

    size not givena minimum of two years

    laser therapy had the lowest overall recurrence rate, but the highest recurrence rate in mixed-location disease

    Who was studied
    patients with pilonidal sinus disease (chronic inflammatory condition near the tailbone)
    What they received
    laser therapy
    Compared with
    microsinusectomy, surgical resection with phenol application, and platelet-rich plasma (PRP)
    Main outcome
    recurrence of pilonidal sinus after treatment
    Quality
    This was a non-randomized comparison without reported group sizes or statistical testing, so the result may not be reliable.
    Limitations
    Abstract does not report sample size, statistical significance, or randomization; outcomes varied by anatomical location suggesting confounding.

    Taken word for word from the abstract

    • population Patients with comparable sociodemographic characteristics were allocated into four treatment groups
    • intervention laser therapy
    • comparator microsinusectomy, surgical resection followed by phenol application, platelet-rich plasma (PRP), and laser therapy
    • primaryOutcome Treatment outcomes were assessed primarily in terms of postoperative recurrence.
    • result laser therapy demonstrated the lowest overall recurrence rate (15.6%). However, in cases of mixed-location PSD, laser treatment was associated with the highest recurrence rate (83.3%).
    • followUp All patients were followed for a minimum of two years.

    Photobiomodul Photomed Laser Surg · PMID 41804956 · Read it on PubMed ↗

  • Stoeckel et al. 2026

    In-Office Pit Excision for Pilonidal Disease Using Needle-Free Local Anesthesia: A Minimally Invasive, Non-Operative Treatment Approach

    Most pits healed after combined laser and excision.Case seriesLow qualityRelated question

    100 peoplereturn in 6 to 8 weeks

    60% of patients healed all pits at first follow-up, and 88% ultimately healed all of their pits

    Who was studied
    patients with pilonidal disease (gluteal crease pits), mean age 18.1 years
    What they received
    in-office pit excision combined with laser follicle ablation and needle-free local anesthesia
    Compared with
    none - single-arm study with no comparison group
    Main outcome
    whether all pits healed at follow-up
    Quality
    This is a single-arm case series without a control group, with 25% of patients lost to follow-up, so the true healing rate and the specific effect of laser cannot be confirmed.
    Limitations
    No comparator group, 25 of 130 patients lost to follow-up, and laser ablation was combined with punch excision so its individual effect cannot be separated.

    Taken word for word from the abstract

    • n 100 were included in the analysis
    • population Mean age was 18.1 years; 50% were male.
    • intervention Laser follicle ablation was followed by punch excision (1.5 or 2 mm) of full-thickness pit epithelium.
    • comparator About 130 patients underwent this technique between February and June 2024; 100 were included in the analysis
    • primaryOutcome 60% patients healed all pits, resolving their condition, with 64% (144/224) of all pits healed.
    • result Ultimately, 88% of patients healed all of their pits.
    • followUp return in 6 to 8 weeks

    Eur J Pediatr Surg · PMID 41461191 · Read it on PubMed ↗

  • Li et al. 2025

    [Clinical efficacy of laser ablation and closure in the treatment of sacrococcygeal pilonidal disease and analysis of risk factors for postoperative recurrence in male patients]

    High healing, low recurrence with laser.RetrospectiveLow quality

    369 peoplenot specified beyond recurrence tracking

    all wounds healed, 5.1% recurrence, higher recurrence risk in those ≤18 years old or with prior SPD surgery

    Who was studied
    patients with sacrococcygeal pilonidal disease (mostly male, some under 18)
    What they received
    laser ablation and closure surgery
    Compared with
    none (single-arm, risk factor analysis for recurrence)
    Main outcome
    wound healing rate and postoperative recurrence
    Quality
    This was a retrospective study without a comparison group, so it cannot show how laser treatment compares to other treatments.
    Limitations
    Retrospective design, no control group, single center, recurrence risk factor analysis limited to males.

    Taken word for word from the abstract

    • n collect clinical data of 369 patients with SPD who underwent laser ablation and closure
    • population The cohort included 313 males and 56 females, with 43 patients aged ≤18 years.
    • intervention laser ablation and closure for the treatment of sacrococcygeal pilonidal disease (SPD)
    • comparator A retrospective observational study was conducted to collect clinical data of 369 patients with SPD who underwent laser ablation and closure
    • primaryOutcome The wound healing rate was 100%, with a median wound healing time of 35 (IQR: 30, 42) days. Postoperative recurrence occurred in 19 patients (5.1%)
    • result The wound healing rate was 100%, with a median wound healing time of 35 (IQR: 30, 42) days. Postoperative recurrence occurred in 19 patients (5.1%), all of whom were male.

    Zhonghua Wei Chang Wai Ke Za Zhi · PMID 41397828 · Read it on PubMed ↗

  • Grgić et al. 2025

    LASER SURGERY FOR PILONIDAL DISEASE - A NOVEL MINIMALLY INVASIVE PROCEDURE

    No results reported.Narrative reviewVery low quality

    size not given2025

    abstract describes the treatment approach but does not report specific outcome data or results

    Who was studied
    people with pilonidal cysts/sinus disease
    What they received
    laser treatment of the pilonidal sinus tract
    Compared with
    other surgical treatments (e.g. excision, flap surgery, phenol)
    Quality
    This is a narrative review describing an experience with laser treatment but reports no outcome data, numbers, or comparative results.
    Limitations
    No patient numbers, no outcome measures, no follow-up, and no quantitative results are reported in this abstract.

    Taken word for word from the abstract

    • population Pilonidal disease (PD) is a common inflammatory disease of the gluteal region
    • intervention We present our experience with laser treatment (Biolitec, Germany) of pilonidal sinus disease.
    • comparator There are many reconstructive techniques such as Karydakis, V-Y flap or Limberg flap.
    • result We present our experience with laser treatment (Biolitec, Germany) of pilonidal sinus disease.

    Acta Clin Croat · PMID 41340801 · Read it on PubMed ↗

  • Canturk et al. 2025

    Combined laser ablation and pit excision for pilonidal sinus: effectiveness, quality of recovery, and patient-reported outcomes

    Good healing, low recurrence with laser.RetrospectiveLow quality

    39 people13.6 ± 3.6 months

    84.6% had treatment success and 15.4% had recurrence, with high patient-reported recovery and satisfaction scores

    Who was studied
    adults with pilonidal sinus disease
    What they received
    diode laser ablation combined with pit excision
    Compared with
    none (single-arm cohort, no comparator group)
    Main outcome
    recurrence and treatment success (no recurrence without re-intervention)
    Quality
    This was a small, retrospective, single-center study with no comparison group, so results may not reliably predict how laser treatment compares to other options.
    Limitations
    Retrospective design, modest sample size, single-center, no comparator group explicitly described.

    Taken word for word from the abstract

    • population Fifty-four adults were treated consecutively
    • intervention minimally invasive method of diode laser ablation combined with pit excision for pilonidal sinus disease
    • comparator This retrospective study aimed to evaluate the efficacy, safety, and patient-reported long-term results of a minimally invasive method of diode laser ablation combined with pit excision for pilonidal sinus disease
    • primaryOutcome The primary endpoints were recurrence and treatment success (no recurrence without re-intervention).
    • result treatment success 84.6% (33/39), recurrence 15.4% (6/39), and delayed healing 20.5% (8/39)
    • n the primary analysis included 39 patients
    • followUp Mean followup was 13.6 ± 3.6 months

    BMC Surg · PMID 41316137 · Read it on PubMed ↗

  • Bilgin et al. 2025

    Comparison of short- and long-term outcomes of diode laser vs. crystallized phenol treatment for pilonidal sinus disease: A propensity score-matched multicentre study

    Similar recurrence; laser healed faster, more pain.RetrospectiveLow qualityRelated question

    644 people45 months (laser) and 40 months (phenol)

    Complications were more common and pain scores higher with laser, with slower return to daily activities, but healing was faster and fewer sessions needed; recurrence and recovery rates were similar between groups

    Who was studied
    young adults with pilonidal sinus disease
    What they received
    diode laser ablation
    Compared with
    crystallized phenol application
    Main outcome
    recovery, recurrence, complications, healing time, and return to daily activities
    Quality
    This is a retrospective study comparing two treatments without a true no-treatment control, so it cannot show whether laser works better than doing nothing, only how it compares to phenol.
    Limitations
    Retrospective design with propensity score matching rather than randomization; compares two active treatments rather than laser versus no treatment or surgery.

    Taken word for word from the abstract

    • population Pilonidal sinus disease (PSD) primarily affects young adults
    • intervention patients treated with laser or phenol were included
    • comparator patients treated with laser or phenol were included
    • primaryOutcome This study compared short- and long-term outcomes of laser versus phenol treatment in PSD.
    • result Complications occurred in 6.8% of laser patients, whereas none were reported in the phenol group. Pain scores were higher in the laser group (2 [1-3] vs. 1 [0-2]). Median follow-up was 45 months (laser) and 40 months (phenol). Return to daily activities was delayed in the laser group, whereas complete healing was slower in the phenol group. Readmission, recurrence and recovery rates were comparable (85%-86%).
    • n 897 eligible patients, 644 were included
    • followUp Median follow-up was 45 months (laser) and 40 months (phenol).

    Colorectal Dis · PMID 41146596 · Read it on PubMed ↗

  • Stoeckel et al. 2026

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

    Numbing cream didn't reduce procedure pain.Randomised trialLow qualityRelated question

    20 people2026

    no significant difference in pain scores between lidocaine cream and placebo

    Who was studied
    patients having laser treatment for pilonidal disease
    What they received
    numbing cream (lidocaine) applied before laser follicle ablation
    Compared with
    placebo cream before laser follicle ablation
    Main outcome
    pain score reported after the laser procedure
    Quality
    Very small crossover trial testing a numbing cream, not the effectiveness of laser treatment itself for pilonidal disease.
    Limitations
    Small sample of 20, only measured pain during the procedure, not disease outcomes like healing or recurrence.

    Taken word for word from the abstract

    • population included patients presenting to the pilonidal care clinic for laser follicle ablation
    • intervention topical anesthetic cream (LMX, 4 % topical lidocaine, Ferndale Laboratories Inc.)
    • comparator or placebo and crossed over between study arms to serve as their own control
    • primaryOutcome the patient was asked their level of discomfort with the laser follicle ablation on a 0-10 Likert pain scale
    • result The mean pain score with LMX was 2.25 (SD 1.94) and placebo 1.78 (SD 1.15) (p = 0.18; Fig. 1).
    • n leaving 20 patients for analysis

    J Pediatr Surg · PMID 41135869 · Read it on PubMed ↗

  • Jazi et al. 2025

    Future of pilonidal cyst surgery: a comparative review of traditional and laser techniques

    Faster recovery, fewer complications with laserNarrative reviewLow quality

    size not given2025

    Laser techniques showed shorter hospital stays, less pain, lower recurrence, and healing rates up to 97%, but were less effective for severe cases and more costly

    Who was studied
    people with pilonidal cysts or sinus
    What they received
    laser-assisted surgery for pilonidal disease
    Compared with
    traditional surgical techniques (excision, flap reconstructions)
    Main outcome
    effectiveness, recovery time, recurrence rates, complications, cosmetics, and costs
    Quality
    This is a non-systematic comparative review of varied studies without pooled statistics, so it cannot reliably establish how well laser treatment works.
    Limitations
    Abstract states additional research is needed to optimize laser procedures and establish long-term outcomes; laser may be less effective in severe or complicated cases.

    Taken word for word from the abstract

    • population Pilonidal disease is a common sacrococcygeal cyst or sinus
    • intervention minimally invasive procedures focusing on laser-assisted
    • comparator traditional surgical techniques including traditional excision with open and closed healing, flap reconstructions
    • primaryOutcome focusing on each method's effectiveness, recovery time, recurrence rates, complications, cosmetics, and costs
    • result Laser techniques showed promising results in reducing hospital stays (for at most 3 h vs. days), postoperative pain, and recurrence rates, with healing rates up to 97%. However, laser methods may be less effective in severe or complicated cases, and they have higher costs.

    BMC Surg · PMID 41094667 · Read it on PubMed ↗

  • Ouali et al. 2025

    International Society of Laser Proctology Position Paper on SiLaC and EPSiT/SiLaC in the Management of Pilonidal Sinus Disease

    Expert opinion, not outcome data.GuidelineVery low qualityRelated question

    size not given2025

    Experts agreed on 10 statements to standardize the laser procedure, based on limited evidence and expert opinion

    Who was studied
    people with pilonidal sinus disease
    What they received
    laser treatment (SiLaC and EPSiT/SiLaC) for pilonidal sinus
    Compared with
    no direct comparator; consensus on technique variations
    Main outcome
    standardizing treatment technique to improve outcomes
    Quality
    This is an expert consensus/position paper based on limited evidence rather than a study measuring patient outcomes.
    Limitations
    Based largely on expert opinion rather than controlled trial data; abstract states evidence is limited.

    Taken word for word from the abstract

    • population Minimally invasive treatment of pilonidal sinus disease (PSD)
    • intervention sinus tract laser closure (SiLaC) and endoscopic pilonidal sinus treatment (EPSiT)
    • comparator there still exists a wide heterogeneity in surgical technique
    • primaryOutcome improving treatment outcomes
    • result ISoLP experts in SiLaC and EPSiT procedures have suggested 10 statements to aid in homogenizing the SiLaC procedure alone and in combination with EPSiT, with the goal of improving treatment outcomes.
    • qualityWhy This position paper is based on the limited evidence from available literature and largely on the expert opinion of ISoLP members

    Lasers Surg Med · PMID 41078023 · Read it on PubMed ↗

  • Lagus et al. 2025

    Comparative analysis of treatment modalities and contributing factors in recurrent pilonidal sinus disease

    Similar reoperation rates, but more recurrences after laser.RetrospectiveLow qualityRelated question

    63 people18.3 months

    about 1 in 5 patients needed re-operation across all groups, but recurrence or residual disease was a more common reason for re-operation after laser treatment compared with direct closure or flap surgery

    Who was studied
    patients with recurrent pilonidal sinus disease
    What they received
    laser treatment as primary or re-operative surgery
    Compared with
    excision with direct closure or flap reconstruction surgery
    Main outcome
    need for re-operation after primary surgery
    Quality
    This was a small retrospective study with only 13 patients in the laser group, making the findings unreliable for drawing firm conclusions.
    Limitations
    Retrospective design, small group sizes (especially laser group n=13), and authors state long-term outcomes are needed to confirm findings.

    Taken word for word from the abstract

    • n data from 63 patients with recurrent pilonidal sinuses treated at the Plastic Surgery Department of Kuopio University Hospital
    • population 63 patients with recurrent pilonidal sinuses treated at the Plastic Surgery Department of Kuopio University Hospital (Kuopio, Finland) between 2010 and 2021
    • intervention Laser treatment (n=13)
    • comparator excision combined with direct closure (n=32) and flap reconstruction (n=18)
    • primaryOutcome ~1 in 5 patients required re-operation after the primary operation
    • result Residual disease or recurrence was more common as a reason for re-operation in the laser group compared with the other groups (direct closure group, P=0.003; flap group, P=0.010).
    • followUp The minimum follow-up time was 18.3 months.

    Exp Ther Med · PMID 41019483 · Read it on PubMed ↗

  • de Kort et al. 2025

    Minimal Invasive Surgical Treatment in Primary Sacrococcygeal Pilonidal Sinus Disease: Phenolization of the Sinus Tract Versus Sinus Laser Assisted Closure; Long-Term Follow-Up of a Comparative Cohort Study

    No clear winner between treatments.RetrospectiveLow quality

    72 people47 months

    Phenolization had fewer patients needing additional surgery (19.4% vs 30.6%) and slightly better pain and general health scores, but overall quality of life measures did not differ significantly; no clear superiority of either technique

    Who was studied
    patients with primary chronic sacrococcygeal pilonidal sinus disease
    What they received
    sinus laser-assisted closure (SiLaC)
    Compared with
    phenolization of the sinus tract
    Main outcome
    need for additional surgery and quality of life/symptoms
    Quality
    This was a retrospective, matched comparative cohort (not randomized) with modest patient numbers from two hospitals, so differences could be due to other factors.
    Limitations
    Not randomized; retrospective record review; small sample size; matched but not controlled for all confounders.

    Taken word for word from the abstract

    • population primary, chronic sacrococcygeal pilonidal sinus disease
    • intervention sinus laser-assisted closure
    • comparator phenolization of the sinus tract
    • n phenolization group (n = 36)
    • n SiLaC group (n = 36)
    • primaryOutcome Patient records were examined for additional surgeries, and quality of life and symptoms were assessed with a questionnaire.
    • result seven patients (19.4%) in the phenolization group (n = 36) required additional surgery and 11 patients (30.6%) in the SiLaC group (n = 36) underwent additional surgery
    • result Both phenolization and sinus laser-assisted closure appear to be feasible for patients with primary SPSD, with no clear superiority of either technique.
    • followUp After a mean follow-up of 47 months

    World J Surg · PMID 40769774 · Read it on PubMed ↗

  • Sekhon Inderjit Singh et al. 2025

    The application of EPSiT in pilonidal sinus disease: an international Delphi consensus study endorsed by the Association of Laparoscopic Surgeons of Great Britain and Ireland (ALSGBI)

    Expert opinions on technique, not effectiveness.GuidelineVery low qualityRelated question

    20 people2025

    Experts reached consensus on 28 statements about EPSiT use, including recommending laser epilation and re-EPSiT for failures, but no clinical outcome data reported

    Who was studied
    patients with pilonidal sinus disease (primary and recurrent, adult and paediatric)
    What they received
    Endoscopic pilonidal sinus treatment (EPSiT)
    Compared with
    no comparator, expert consensus opinions gathered
    Main outcome
    expert agreement on statements regarding EPSiT application and protocols
    Quality
    This is an expert opinion consensus study, not a clinical trial, so it cannot show whether the treatment actually works.
    Limitations
    Delphi consensus of expert opinion only, no patient outcome data, small panel of 20 experts

    Taken word for word from the abstract

    • n Twenty experts from six countries participated in all rounds
    • population primary and recurrent adult and paediatric patients with pilonidal sinus disease
    • intervention Endoscopic pilonidal sinus treatment (EPSiT) is a novel, minimally invasive surgical technique
    • comparator Expert international panellists were identified and recruited to participate.
    • primaryOutcome gather and understand expert international opinions on EPSiT and develop recommendations for its application
    • result Our experts agreed on 28 statements including: the absence of absolute contraindications to EPSiT; administering intravenous induction antibiotics routinely but not post-operative oral antibiotics; recommending laser epilation; offering re-EPSiT to the informed patient after first and second procedure failures

    Tech Coloproctol · PMID 40736584 · Read it on PubMed ↗

  • Emral et al. 2025

    Evaluation of laser ablation for recurrent pilonidal sinus disease: treatment success, recurrence rates, and patient outcomes

    Most healed, some recurredRetrospectiveLow quality

    37 people9.6 months

    70.3% of patients healed completely without recurrence, 21.6% had recurrence, 13.5% had superficial infections

    Who was studied
    patients with recurrent pilonidal sinus disease
    What they received
    laser ablation
    Compared with
    none (single-arm, before/after outcomes)
    Main outcome
    complete healing without recurrence
    Quality
    This was a small retrospective study of one treatment with no comparison group, so it cannot show if laser worked better than other options.
    Limitations
    Retrospective design, no control group, small sample size

    Taken word for word from the abstract

    • n A retrospective analysis of 37 patients with recurrent pilonidal sinus disease
    • population patients with recurrent pilonidal sinus disease
    • intervention treated with laser ablation between January 2022 and January 2025
    • comparator A retrospective analysis of 37 patients with recurrent pilonidal sinus disease treated with laser ablation
    • primaryOutcome treatment success, recurrence rates, complications, and recovery outcomes
    • result 70.3% of patients achieved complete healing without recurrence, while 21.6% experienced recurrence within a mean follow-up of 9.6 months. Five patients (13.5%) developed superficial infections
    • followUp mean follow-up of 9.6 months

    Lasers Med Sci · PMID 40522552 · Read it on PubMed ↗

  • Pall 2025

    The Versatile Applications of Triple-Wavelength Diode Laser (810, 940, and 1060 nm) in Aesthetic Treatments, Follicular Disorders, and Chronic Inflammatory Conditions in the Asian Population: Case Report Collection

    No separate result reported for pilonidal cysts.RetrospectiveVery low qualityRelated question

    size not given2025

    overall hair reduction of 82.9% and a mean GAIS improvement of 3.4 out of 4 across all treated conditions combined, with no outcome reported specifically for pilonidal sinus disease

    Who was studied
    adults with skin type IV with facial hirsutism and follicular disorders, including trichostasis spinulosa, pilonidal sinus disease, and hidradenitis suppurativa
    What they received
    high-power triple-wavelength diode laser (810, 940, and 1060 nm)
    Compared with
    none described; before-and-after assessment only
    Main outcome
    hair count reduction and overall aesthetic improvement (GAIS score)
    Quality
    This is a small retrospective case collection mixing several different skin conditions with no control group, and it does not separate out results for pilonidal sinus disease.
    Limitations
    Retrospective design, no comparator group, results pooled across different conditions (hirsutism, trichostasis spinulosa, pilonidal sinus disease, hidradenitis suppurativa) without separate outcomes for pilonidal cysts, and sample size not reported.

    Taken word for word from the abstract

    • design This retrospective study was conducted at the Escallent Institute of Lasers & Aesthetic Medicine (EILAM), Gurugam, India, using a Primelase device with a triple-wavelength diode laser.
    • population adults with skin type IV who presented with facial hirsutism and follicular disorders, including trichostasis spinulosa, pilonidal sinus disease, and hidradenitis suppurativa
    • intervention high-power triple-wavelength diode laser (810, 940, and 1060 nm)
    • comparator Efficacy was assessed using hair counting and the Global Aesthetic Improvement Scale (GAIS), whereas safety was evaluated based on reported adverse effects, such as pain, erythema, and edema.
    • primaryOutcome Efficacy was assessed using hair counting and the Global Aesthetic Improvement Scale (GAIS)
    • result The GAIS scores indicated a mean improvement of 3.4 ± 0.4 out of 4, representing a 50%-75% improvement. Hair counting revealed a statistically significant hair reduction of 82.9% ± 15.4%, with reductions ranging from 56% to 100%.

    J Cosmet Dermatol · PMID 40464115 · Read it on PubMed ↗

  • Evirgen et al. 2025

    The Efficacy of Punch Biopsy and Diode Laser Combination in the Treatment of Pilonidal Sinus: A Comparative Study Across Different Patient Groups

    Fewer complications in simple cases.Prospective cohortLow quality

    187 people2025

    Simple cases had lower operative time, pain, and healing duration, with 3.7% recurrence versus 14.1% in complicated cases

    Who was studied
    patients with pilonidal sinus disease, divided into simple and complicated cases
    What they received
    pit excision with punch biopsy needle combined with 1470 nm diode laser closure
    Compared with
    simple disease group versus complicated disease group (no prior abscess vs history of abscess drainage)
    Main outcome
    operative time, postoperative pain, wound-healing duration, recurrence rate, and return-to-work time
    Quality
    This was a single-group prospective study without a comparator treatment or randomization, so it cannot show whether laser is better than other options.
    Limitations
    No control group receiving a different treatment; abstract does not report blinding or long-term follow-up duration beyond immediate postoperative period.

    Taken word for word from the abstract

    • n A prospective study conducted included 187 patients who underwent laser treatment for pilonidal sinus.
    • population Patients were divided into two groups based on the severity of the disease: Group 1 (simple group) included patients who had no prior abscess formation and had one or two sinus openings, while Group 2 (complicated group) comprised patients with a history of abscess drainage and more two extensive sinus openings.
    • intervention The sinus openings were excised using a punch biopsy needle and subsequently closed with a diode laser probe.
    • comparator Patients were divided into two groups based on the severity of the disease: Group 1 (simple group) included patients who had no prior abscess formation and had one or two sinus openings, while Group 2 (complicated group) comprised patients with a history of abscess drainage and more two extensive sinus openings.
    • primaryOutcome operative time (12.22 ± 1.72 min), postoperative pain scores and wound-healing duration were significantly lower in the simple group compared to the complicated group (p < 0.001)
    • result The recurrence rates were 3.7% in the simple group and 14.1% in the complicated group.

    J Clin Med · PMID 40364084 · Read it on PubMed ↗

  • Ouali 2025

    SiLaC® with EPSiT®: early outcomes of laser-endoscopic therapy for pilonidal sinus

    Low pain, fast healing, few recurrences.RetrospectiveLow quality

    83 peopleat least 6 months of follow-up; a subset was followed up to 1 year

    low pain, fast healing, and 3.6% recurrence at 6 months

    Who was studied
    young adults with pilonidal sinus disease, aged 15-50
    What they received
    combined laser ablation (SiLaC) and endoscopic treatment (EPSiT) for pilonidal sinus
    Compared with
    none (no comparison group)
    Main outcome
    pain, healing time, and recurrence after treatment
    Quality
    This was a retrospective single-center study with no comparison group, so it cannot show the treatment works better than alternatives.
    Limitations
    Retrospective design, single center, no control group, relatively short follow-up (6 months, with only a subset to 1 year).

    Taken word for word from the abstract

    • n This retrospective, single-center study included 83 patients (aged 15-50)
    • population Pilonidal sinus disease (PSD) commonly affects young adults
    • intervention a combined approach using Sinus Laser Ablation of the Cyst (SiLaC®) and Endoscopic Pilonidal Sinus Treatment (EPSiT®)
    • comparator This retrospective, single-center study included 83 patients
    • primaryOutcome Data on operative time, Visual Analogue Scale (VAS) pain score, healing time to complete epithelialization, recurrence, and time to return to work were collected.
    • result Mean VAS pain score at 24 h was 1.2 ± 0.6, and 92.3% of patients resumed work or normal activities within 24 h. Mean healing time was 17.3 days, with 95% achieving complete epithelialization by 3 weeks. The overall recurrence rate at 6 months was 3.6% (3/83).
    • followUp All patients had at least 6 months of follow-up; a subset was followed up to 1 year.

    Front Surg · PMID 40352310 · Read it on PubMed ↗

  • El Deen et al. 2025

    A Comparitive Study Between Early Outcomes of Laser and Lay-Open Technique in Management of Simple Pilonidal Sinus

    Faster recovery, less pain with laserRandomised trialLow quality

    40 people2025

    Laser therapy had shorter operative time, shorter hospital stay, lower pain scores, and faster wound healing than lay-open surgery, with similar recurrence and infection rates

    Who was studied
    patients with simple/chronic pilonidal sinus disease
    What they received
    laser therapy (SiLaT, diode laser)
    Compared with
    lay-open technique (sinotomy)
    Main outcome
    postoperative outcomes including operative time, hospital stay, pain scores, healing time, complications, and recurrence rates
    Quality
    Small trial of only 40 patients with short-term follow-up, so results may not be reliable or generalizable long-term.
    Limitations
    Small sample size; only early postoperative outcomes assessed; authors call for long-term studies.

    Taken word for word from the abstract

    • n Prospective randomized comparative study including 40 patients, divided into two equal groups
    • population evaluate the early postoperative outcomes of laser therapy compared to the lay-open technique in the treatment of chronic pilonidal sinus disease
    • intervention PS treated with diode laser therapy (SiLaT)
    • comparator the lay-open group: PS treated with lay-open (sinotomy)
    • primaryOutcome Postoperative outcomes such as operative time, hospital stay, pain scores, healing time, complications, and recurrence rates were analyzed.
    • result Operative time was significantly shorter in the SiLaT group (18.4 ± 2.1 min vs. 26.2 ± 3.7 min, p = 0.022). Hospital stay was shorter in the SiLaT group (6.60 ± 1.47 h vs. 15.10 ± 5.52 h, p < 0.001). Pain scores were lower in the SiLaT group (2.30 ± 0.92 vs. 4.80 ± 1.01, p < 0.001). Wound healing was significantly faster in the SiLaT group (10.1 ± 2.7 days vs. 34.1 ± 15.1 days, p < 0.0001). Recurrence rates (p = 0.998) and surgical site infection (p = 1.00) were comparable among both groups.

    Lasers Surg Med · PMID 40108765 · Read it on PubMed ↗

  • Stoeckel et al. 2025

    Gender Differences in Adolescent Pilonidal Disease

    No efficacy data on laser.RetrospectiveVery low qualityRelated question

    1,356 people2025

    similar rates of laser follicle ablation were used in both genders, but no outcome or effectiveness data for laser treatment itself were reported

    Who was studied
    adolescents with pilonidal disease, by gender
    What they received
    laser follicle ablation (among other clinic treatments)
    Compared with
    other treatments such as pit picking and incision and drainage, compared between female and male patients
    Main outcome
    gender differences in pilonidal disease severity, quality of life impact, and treatment tolerance
    Quality
    This is a retrospective cohort study comparing genders, not designed to test whether laser treatment works, and it reports only usage rates, not outcomes of laser therapy.
    Limitations
    Retrospective design; study focuses on gender differences rather than evaluating laser treatment efficacy; no outcome data for laser ablation given.

    Taken word for word from the abstract

    • n Of 1356 patients with pilonidal disease, 562 (41 %) were female and 794 male.
    • population Pilonidal disease is a common, disruptive condition in adolescents.
    • intervention with similar rates of laser follicle ablation (53 % vs 55 %; p-value = 0.45)
    • comparator More females underwent pit picking on their first clinic visit (33 % vs 27 %; p-value = 0.011) and incision and drainage (6 % vs 3 %; p-value = 0.01), with similar rates of laser follicle ablation (53 % vs 55 %; p-value = 0.45).
    • primaryOutcome We studied the effects of pilonidal disease on adolescents by gender.
    • result with similar rates of laser follicle ablation (53 % vs 55 %; p-value = 0.45)

    J Pediatr Surg · PMID 40086161 · Read it on PubMed ↗

  • Gojayev et al. 2025

    Comparative Outcomes of Surgical Techniques for Pilonidal Sinus: A Turkish Retrospective Study

    Faster recovery, higher satisfaction with laser.RetrospectiveLow quality

    422 people2025

    laser group had shorter surgery and hospital stay, less pain, faster return to activity, and higher satisfaction

    Who was studied
    adults with pilonidal sinus disease who had surgery
    What they received
    laser pilonidotomy
    Compared with
    primary midline closure, Karydakis flap, and Limberg flap surgeries
    Main outcome
    complications, recurrence, recovery times, and satisfaction
    Quality
    This is a retrospective comparison of surgical groups, not a randomized trial, so differences between groups could be due to other factors.
    Limitations
    Retrospective design; authors state studies with larger samples and longer follow-up are needed.

    Taken word for word from the abstract

    • n The data of 476 patients who underwent surgery for pilonidal sinus disease in our clinic between January 2011 and September 2022 were retrospectively evaluated. After 54 patients were excluded, the remaining patients were divided into 4 groups: PMC (n=228), LF (n=82), KF (n=53), and LP (n=59).
    • population adult patients with pilonidal sinus disease
    • intervention laser pilonidotomy (LP)
    • comparator primary midline closure (PMC), Karydakis flap (KF), Limberg flap (LF)
    • primaryOutcome Patient characteristics, surgical findings, and quality of life outcomes were compared between the groups.
    • result Hospital stay was significantly shorter in the LP group (mean, 8 h; P<0.001). Pain-free toilet sitting time, pain-free walking time, and return to work time were statistically significantly shorter in the LP group (all P<0.001). According to the Likert scale, the satisfaction rate of the LP group was significantly higher (P<0.001).
    • limitations studies with larger samples and longer follow-up periods are needed

    Med Sci Monit · PMID 39995244 · Read it on PubMed ↗

  • Qin et al. 2025

    Efficacy and safety of laser ablation for recurrent pilonidal sinus: a systematic review and meta‑analysis

    Mostly healed short-term, less durable long-term.Meta-analysisLow qualityRelated question

    137 people12 months or less; some studies exceeding 12 months

    about 82% of patients healed, with lower healing rates after more than 12 months follow-up

    Who was studied
    patients with recurrent pilonidal sinus after prior surgery
    What they received
    laser ablation of the sinus tract
    Compared with
    none (single-arm pooled outcomes across studies; some had pit picking combined)
    Main outcome
    healing rate after treatment
    Quality
    pooled from only seven small studies with high variability between them and no randomized comparison group.
    Limitations
    high heterogeneity between studies (I2=69%), declining healing rates with longer follow-up, and lack of randomized controlled trials.

    Taken word for word from the abstract

    • population 137 patients with recurrent pilonidal sinus were included
    • intervention laser ablation treatment
    • comparator the difference in efficacy between combined pit picking and laser ablation alone was not statistically significant
    • primaryOutcome The primary outcome measure was the healing rate after laser ablation
    • result The pooled healing rate across these studies was 81.9% (95% CI, 65.4-94.6%; I2 = 69.12%; p < 0.01)
    • result for studies with a follow-up duration exceeding 12 months, the pooled healing rate was 74.5%
    • n In total, 137 patients with recurrent pilonidal sinus were included, of whom 112 achieved healing

    Int J Colorectal Dis · PMID 39969579 · Read it on PubMed ↗

  • Shlyk et al. 2025

    Current surgical practices and attitudes toward pilonidal sinus disease among Russian surgeons: A national survey

    No efficacy data reported.RegistryVery low qualityRelated question

    158 people2025

    About half of surgeons had access to laser therapy, but only 16% actually used laser-assisted closure; the study reports practice patterns, not treatment outcomes

    Who was studied
    Russian surgeons who treat pilonidal sinus disease
    What they received
    use of laser therapy for pilonidal sinus disease
    Compared with
    other surgical techniques such as excision with midline closure, open healing, marsupialization
    Main outcome
    survey responses describing current surgical practices and attitudes toward pilonidal sinus disease
    Quality
    This is a survey of surgeons' practice habits, not a study comparing patient outcomes, so it cannot show whether laser treatment actually works.
    Limitations
    Self-reported survey data on practice patterns, not a comparative outcome study of laser versus other treatments

    Taken word for word from the abstract

    • n Of the 158 respondents
    • population The survey targeted colorectal and general surgeons
    • intervention About half of surgeons had access to laser therapy for treating PSD, but sinus laser-assisted closure was used by only 16%
    • comparator The most popular surgical procedures were excision with midline closure (68%), open healing (62%) and marsupialization (59%)
    • primaryOutcome The aim of this study was to analyse and assess current PSD practice, diagnostic and surgical approaches, training and attitudes among Russian surgeons
    • result About half of surgeons had access to laser therapy for treating PSD, but sinus laser-assisted closure was used by only 16%

    Colorectal Dis · PMID 39920899 · Read it on PubMed ↗

  • Janek et al. 2025

    Laser Hair Removal May Be a Primary Treatment of Pilonidal Disease: A Pilot Study

    Fewer needed surgery, better quality of life.Prospective cohortLow quality

    22 people18 months

    40% of patients who completed laser sessions resolved without surgery; among those who still needed surgery, 67% resolved after one operation; quality of life scores improved

    Who was studied
    adolescents and young adults ages 13-35 with moderate to severe pilonidal disease referred for surgery
    What they received
    laser hair removal with long-pulsed Alexandrite laser as primary treatment
    Compared with
    no comparator group; outcomes tracked before/after laser treatment and with subsequent surgery if needed
    Main outcome
    resolution without surgery, and recurrence rates after surgery in those who still needed it
    Quality
    This was a small, single-center pilot study with no comparison group, so it can't prove the laser itself caused the improvement.
    Limitations
    Small sample size, no control group, some patients withdrew before completing treatment, single center and single dermatologist performing laser treatment.

    Taken word for word from the abstract

    • n Twenty-two patients were enrolled
    • population Patients ages 13-35 with moderate to severe disease who were referred for surgical excision were recruited.
    • intervention Participants underwent 3-8 treatment sessions with the long-pulsed--Alexandrite (755 nm) laser by a dermatologist until hair removal endpoints were met.
    • comparator Patients with persistent symptoms after LHR underwent subsequent excision.
    • primaryOutcome Primary outcomes included resolution rates without surgical intervention and recurrence rates following surgical resection.
    • result Six of 15 (40 %) who completed laser treatments had resolution without surgical intervention. Nine patients underwent surgery, of which 6 (67 %) resolved after one surgery
    • result Quality of life scores improved after laser treatments (DLQI mean change -4.6, and Children's DLQI mean change -6.0)

    J Pediatr Surg · PMID 39893840 · Read it on PubMed ↗

  • Darnis et al. 2025

    Management of pilonidal sinus and recurrences in 2025

    Similar recurrence, easier recovery.Narrative reviewVery low qualityRelated question

    size not given2025

    equivalent recurrence rate to excision, but easier recovery and avoids difficult wound care

    Who was studied
    people with pilonidal sinus, including those with treatment failures or recurrences
    What they received
    minimally invasive techniques including laser treatment
    Compared with
    radical excision followed by secondary healing
    Main outcome
    recurrence rate
    Quality
    This is a narrative review describing general treatment strategies without presenting original study data or numbers for laser treatment.
    Limitations
    No patient numbers, no study design details, no statistics are given for laser treatment specifically; it is a general narrative review of pilonidal sinus management.

    Taken word for word from the abstract

    • intervention Minimally invasive techniques are being developed that combine the extraction of foreign bodies and mechanical debridement or thermal or chemical cautery of the granulomatous walls.
    • comparator Radical excision followed by secondary healing is the most commonly performed option.
    • primaryOutcome at the cost of a recurrence rate equivalent to that from excision techniques
    • result They avoid complex and unpleasant nursing care of secondarily healing wounds, at the cost of a recurrence rate equivalent to that from excision techniques.
    • population The treatment of surgical failures is complex, and combines comprehensive patient care
    • intervention Minimally invasive treatments, particularly laser treatments, have their place in these difficult situations.

    J Visc Surg · PMID 39875233 · Read it on PubMed ↗

  • Emral et al. 2024

    Evaluating efficacy and outcomes: comparison of laser treatment and crystallized phenol in pilonidal sinus disease

    Faster healing, less pain than phenol.RetrospectiveLow quality

    121 people2024

    laser treatment had faster healing and less pain than phenol

    Who was studied
    patients with pilonidal sinus disease
    What they received
    laser ablation
    Compared with
    crystallized phenol application
    Main outcome
    wound healing time and post-surgery pain scores
    Quality
    This was a retrospective review comparing two treatments without randomization, so differences between patient groups could affect results.
    Limitations
    Retrospective design; not randomized; data reviewed after the fact rather than controlled prospectively.

    Taken word for word from the abstract

    • population patients treated for pilonidal sinus disease
    • intervention laser ablation
    • comparator crystallized phenol application
    • primaryOutcome wound healing period and postoperative VAS values
    • result Wound healing was faster and postoperative pain was less in the laser group compared to the phenol group.
    • n A total of 121 patients were included in the study, with 51 receiving laser ablation and 70 receiving crystallized phenol application.

    Front Surg · PMID 39834506 · Read it on PubMed ↗

  • Andrew et al. 2025

    Laser hair depilation therapy for pilonidal sinus disease: a 5-year, retrospective experience in a university teaching hospital in the UK, 2017-2023

    Mostly improved or healed with laser.RetrospectiveLow quality

    97 people2025

    more laser sessions predicted symptom resolution; in patients treated with laser alone (no surgery), 78% improved or healed; surgery type was not linked to improvement; one recurrence and no complications

    Who was studied
    patients with pilonidal sinus disease referred for laser hair removal, mostly young men
    What they received
    laser hair depilation therapy
    Compared with
    no formal comparator; outcomes compared by number of laser sessions and whether surgery was also done
    Main outcome
    improvement or healing of pilonidal sinus disease
    Quality
    This is a retrospective review of medical records without a control group, so it cannot prove the laser itself caused the improvement.
    Limitations
    Retrospective design, no control group, single center, outcome categorization may be subjective.

    Taken word for word from the abstract

    • n Patient demographics, PSD clinical stage, laser type, number of laser sessions, surgical intervention and treatment outcomes were extracted from electronic medical records of patients (n = 97) referred for laser hair depilation between 2017 and 2023.
    • population Most patients affected were male (77%). The median age was 22 years (interquartile range 20-28).
    • intervention Laser hair depilation is an established adjunct to surgical treatment for PSD.
    • comparator Neither surgical intervention nor the type of surgery (incision, excision, modified flap, or endoscopic surgical intervention) showed a significant association with improvement in PSD (P = 0.47 and P = 0.65, respectively).
    • primaryOutcome Treatment outcomes were categorized as improvement (healed, improved) or no improvement of underlying PSD.
    • result In the subgroup of patients who did not undergo surgery (n = 32, 33%), 25 patients (78%) had improvement or healing in their PSD.
    • result The number of laser hair removal sessions was the only predictive factor for symptom resolution (P < 0.001).
    • result No complications were reported and there was only one case of recurrence.

    Clin Exp Dermatol · PMID 39815683 · Read it on PubMed ↗

  • Akyol 2024

    Sinus laser therapy versus Karydakis flap procedure in the management of pilonidal sinus disease: a comparative analysis of intraoperative parameters and postoperative outcome

    Less pain, faster recovery, similar cureRetrospectiveLow quality

    106 people2024

    laser therapy had shorter operative time, less pain, and faster return to work, with similar complication and recurrence rates

    Who was studied
    patients with pilonidal sinus disease
    What they received
    sinus laser therapy (SiLaT)
    Compared with
    Karydakis flap surgery
    Main outcome
    operative time, pain, return to work, complications, and recurrence
    Quality
    this was a retrospective comparison without randomization, so differences between groups could be due to other factors, not just the treatment.
    Limitations
    retrospective design, not randomized

    Taken word for word from the abstract

    • population patients with pilonidal sinus disease (PSD)
    • n A total of 106 patients with PSD
    • intervention sinus laser therapy (SiLaT)
    • comparator Karydakis flap procedure
    • primaryOutcome postoperative (day 1) pain intensity-visual analog scale (VAS) scores, time to return to work after surgery (days), complication rate, and recurrence rate
    • result significantly shorter operative time [median (min-max) 17 (12-28) versus 27 (20-44) min, p = 0.001], lower pain scores [3 (1-4) versus 5 (3-7), p = 0.001], and earlier return to work [1 (1-3) versus 10 (5-20) days, p = 0.001]
    • result no significant difference was noted in complication and recurrence rates between the KF and SiLaT groups
    • limitations retrospective study

    Tech Coloproctol · PMID 39699772 · Read it on PubMed ↗

  • Darnis et al. 2024

    Does the holmium laser have a place in the treatment of pilonidal cysts? (Pilolas study)

    Similar healing, more pain and complications.RetrospectiveLow quality

    size not givenup to a year after the procedure

    healing rate was 90.7% at one month, similar to SiLaT laser, but with more pain, infection, and recurrence

    Who was studied
    people treated for pilonidal cysts
    What they received
    holmium laser treatment
    Compared with
    SiLaT laser treatment
    Main outcome
    cure (healing) rate one month after treatment
    Quality
    This was a retrospective study without a direct control group, comparing results to another laser method from prior data, which makes the comparison less reliable.
    Limitations
    Retrospective design; comparison to SiLaT laser was indirect, not a randomized head-to-head trial; follow-up for complications extended up to a year but methods for tracking this were not detailed.

    Taken word for word from the abstract

    • primaryOutcome Retrospective cohort study with the primary endpoint being the cure rate one month after treatment.
    • result healing rate at 1 month was 90.7%
    • result Holmium laser does not differ from SiLaT laser in the healing rate of pilonidal cysts after treatment. However, it is characterised by a moderately higher incidence of complications
    • intervention the holmium laser instead of the SiLaT laser in the treatment of pilonidal cysts
    • comparator the holmium laser instead of the SiLaT laser in the treatment of pilonidal cysts
    • population treatment of pilonidal cysts
    • followUp pain that can persist for up to a year after the procedure

    Lasers Med Sci · PMID 39578271 · Read it on PubMed ↗

  • Shinde et al. 2024

    Advancements in Surgical Approaches for Sacrococcygeal Pilonidal Sinus: A Comprehensive Review

    No specific results reported.Narrative reviewVery low qualityRelated question

    size not given2024

    The abstract summarizes that the review compares techniques but does not give specific results or data for laser treatment

    Who was studied
    people with pilonidal sinus (a cavity/sinus near the tailbone)
    What they received
    newer surgical techniques including endoscopic and laser-assisted procedures
    Compared with
    traditional surgery such as excision with primary closure
    Main outcome
    clinical outcomes, recurrence rates, complications, and patient satisfaction
    Quality
    This is a narrative review with no reported study data, numbers, or statistical results, so it cannot show whether laser treatment works.
    Limitations
    No specific outcome data, numbers, or statistics are given for laser-assisted treatment; it is a general overview rather than a study with results.

    Taken word for word from the abstract

    • population Sacrococcygeal pilonidal sinus (SPS) is a condition involving the formation of a cavity in the lower back region.
    • intervention recent innovations like endoscopic and laser-assisted techniques
    • comparator traditional procedures, such as excision with primary closure
    • primaryOutcome assessing clinical outcomes, recurrence rates, complications, and patient satisfaction
    • result this review seeks to identify the most effective surgical strategies for SPS

    Cureus · PMID 39364530 · Read it on PubMed ↗

  • Jo et al. 2024

    Peri anal region is an overlooked location for pilonidal recurrence after surgical excision and closure - A case series

    Wounds healed with laser hair removal.Case seriesVery low qualityRelated question

    5 people2024

    all five patients' wounds healed

    Who was studied
    patients with recurrent pilonidal disease and perianal wounds after previous surgical excision and flap closure
    What they received
    regular manual and laser epilation (hair removal), with one patient also undergoing a Gips procedure
    Compared with
    none (no comparison group)
    Main outcome
    wound healing of perianal pilonidal wounds
    Quality
    This is a tiny case series of only 5 patients with no comparison group, so it cannot reliably show whether laser treatment itself works.
    Limitations
    Very small sample size, no control group, combined with manual epilation and sometimes surgery, so the effect of laser alone cannot be separated.

    Taken word for word from the abstract

    • population Five pilonidal patients with recurrent disease after surgical excision and flap closure were referred to our Pilonidal Care Clinic. All five were found to have perianal wounds.
    • intervention Each patient was treated with regular manual and laser epilation and only one patient required a Gips procedure.
    • comparator Each patient was treated with regular manual and laser epilation and only one patient required a Gips procedure.
    • primaryOutcome All wounds were successfully healed.
    • result All wounds were successfully healed.
    • n Five pilonidal patients with recurrent disease after surgical excision and flap closure were referred to our Pilonidal Care Clinic.

    Int J Surg Case Rep · PMID 39357489 · Read it on PubMed ↗

  • Karita et al. 2024

    Long-term follow-up of pilonidal sinus disease treated by radial laser surgery

    About 1 in 7 recurredRetrospectiveLow quality

    83 peoplemedian 5.2 years, range 1.5 to 7.4 years

    14.5% recurrence rate and 27.7% needed a second operation over a median 5.2 years follow-up

    Who was studied
    patients with pilonidal sinus disease
    What they received
    radial laser surgery
    Compared with
    none (single-arm, before/after outcomes only)
    Main outcome
    long-term recurrence of pilonidal sinus disease
    Quality
    This is a retrospective single-group study with no comparison group, so it cannot show whether laser works better than other treatments.
    Limitations
    Retrospective design, no control group for comparison

    Taken word for word from the abstract

    • n We retrospectively studied the medical records of 83 patients who underwent the radial laser procedure for PSD between January 2017 and September 2019.
    • population patients who underwent the radial laser procedure for PSD
    • intervention radial laser procedure for PSD
    • comparator Our follow-up time was a median of 5.2 years, range 1.5 to 7.4 years.
    • primaryOutcome Twelve patients had a PSD recurrence after their laser procedure, which gives a recurrence rate of 14.5%
    • result Twelve patients had a PSD recurrence after their laser procedure, which gives a recurrence rate of 14.5% (95% CI 8.2%-23.2%).
    • result A total of 23 patients (27.7%; 95% CI 19.0-38.0) underwent a reoperation, 11 patients due to postoperative infection or prolonged recovery and 12 patients due to PSD recurrence.
    • followUp Our follow-up time was a median of 5.2 years, range 1.5 to 7.4 years.

    Langenbecks Arch Surg · PMID 39174833 · Read it on PubMed ↗

  • Romanova et al. 2024

    Adolescent pilonidal disease laser treatment (a-PiLaT): a pilot study

    Some complications and recurrences seen.Case seriesVery low quality

    17 people24.5 ± 16.8 months

    24% complication rate and 18% recurrence rate, with favorable scar scores

    Who was studied
    adolescents aged 10-17 with pilonidal disease
    What they received
    pilonidal disease laser treatment (PiLaT)
    Compared with
    none (compared to literature outcomes in adults)
    Main outcome
    complication and recurrence rates after treatment
    Quality
    This is a small, retrospective case series without a comparison group, so it cannot show whether laser treatment works better than other options.
    Limitations
    Retrospective design, small sample size, no control group, single-center experience.

    Taken word for word from the abstract

    • n A total of 17 consecutive patients (n = 12 female, 71%) underwent a-PiLaT.
    • population PiLaT performed in adolescents aged 10-17 years
    • intervention pilonidal disease laser treatment (PiLaT)
    • comparator complication and recurrence rates comparable to those reported in the literature for adults
    • primaryOutcome complication rate of 24% (n = 4) and recurrence rate of 18% (n = 3)
    • result complication rate of 24% (n = 4) and recurrence rate of 18% (n = 3)
    • followUp the mean follow-up period was 24.5 ± 16.8 months

    Tech Coloproctol · PMID 39141158 · Read it on PubMed ↗

  • Emengo et al. 2024

    Standardized pilonidal protocol as rescue therapy for excision-refractory pilonidal disease

    Combined protocol healed resistant cystsCase seriesLow qualityRelated question

    34 peoplemedian follow-up 405 days

    all patients achieved complete healing after a median of 52 days, with 14.7% recurring

    Who was studied
    patients with pilonidal disease that came back or did not heal after one or more prior surgeries
    What they received
    standardized minimally invasive protocol with wound care, regular manual or laser hair removal, and selective debridement/pit opening
    Compared with
    patients' own prior surgical treatment history, no separate control group
    Main outcome
    complete resolution of pilonidal symptoms and recurrence rate
    Quality
    This was a single-arm study of a small group of patients with no comparison group, so it can't show whether laser hair removal itself caused the improvement.
    Limitations
    No control group; combines laser epilation with wound care and selective surgical debridement so the effect of laser alone can't be separated; small sample of patients with especially severe, treatment-resistant disease.

    Taken word for word from the abstract

    • n We treated 34 refractory patients (23 males) with median follow-up 405 days.
    • population symptomatic patients who underwent ≥ 1 pilonidal excision prior to presentation at our clinic
    • intervention standardized protocol incorporating local wound care, regular manual/laser epilation, and selective debridement/pit trephination
    • comparator Prior to our clinic, 27 received one surgery
    • primaryOutcome All patients achieved complete resolution after median 52 days.
    • result All patients achieved complete resolution after median 52 days. Five (14.7%) recurred
    • followUp median follow-up 405 days

    Pediatr Surg Int · PMID 39141128 · Read it on PubMed ↗

  • Yildirim et al. 2024

    Results of Laser-assisted Closure (SiLaC) Surgery in Pilonidal Sinus Disease: Factors Associated With Success

    Most patients healed with laser treatmentRetrospectiveLow quality

    64 people17.0±8.06 months (range: 3 to 36)

    85.9% recovery rate, 14% complication rate; higher BMI and more advanced disease linked to lower success

    Who was studied
    adults with pilonidal sinus disease treated at a tertiary care hospital
    What they received
    laser-assisted closure of the pilonidal sinus tract (SiLaC)
    Compared with
    none (single group, outcomes compared between recovered and non-recovered patients)
    Main outcome
    recovery (healing) and recurrence after treatment
    Quality
    this was a retrospective single-group study without a comparison treatment, so it cannot show if laser worked better than other options.
    Limitations
    retrospective design, no control group, single center, moderate sample size

    Taken word for word from the abstract

    • n The study cohort consisted of 64 patients.
    • population All adult patients treated with this procedure between March 2020 and December 2023 were included in the study.
    • intervention Pilonidal sinus treatment with sinus laser-assisted closure (SiLaC) method
    • comparator Univariate analysis was performed between recovered and non-recovered patients to find the factors influencing successful treatment.
    • primaryOutcome recurrence rates of the patients were compared
    • result Our recovery rate was 85.9%. The complication rate was 14%
    • followUp The mean follow-up period was 17.0±8.06 months (range: 3 to 36)

    Surg Laparosc Endosc Percutan Tech · PMID 39140695 · Read it on PubMed ↗

  • Dhole et al. 2024

    Advancements and Innovations in the Surgical Management of Sacrococcygeal Pilonidal Sinus: A Comprehensive Review

    No specific results reported.Narrative reviewVery low qualityRelated question

    size not given2024

    abstract does not give specific outcome data, only notes laser therapy as a recent advancement discussed in the review

    Who was studied
    people with sacrococcygeal pilonidal sinus (a chronic cyst/tract near the tailbone)
    What they received
    laser therapy and other surgical innovations for pilonidal sinus
    Compared with
    conventional excision and flap surgical procedures
    Main outcome
    postoperative pain, recurrence rates, and patient satisfaction
    Quality
    this is a general narrative review that summarizes topics without reporting specific data, numbers, or comparative results for laser therapy.
    Limitations
    no original data, no numbers, no comparative results reported, recommends further prospective studies

    Taken word for word from the abstract

    • population Sacrococcygeal pilonidal sinus (SPS) is a common condition characterized by the formation of a sinus tract or cavity in the sacrococcygeal region, often containing hair and debris.
    • intervention Recent advancements, such as laser therapy, radiological guidance techniques, and robotic-assisted surgery, are also examined.
    • comparator current surgical techniques, including conventional excision, flap procedures, and minimally invasive approaches
    • primaryOutcome The key findings from outcomes research are summarized, including postoperative pain management, recurrence rates, and patient satisfaction.
    • result Recent advancements, such as laser therapy, radiological guidance techniques, and robotic-assisted surgery, are also examined.

    Cureus · PMID 38933617 · Read it on PubMed ↗

  • Draullette et al. 2024

    SiLaT: A paradigm shift in the treatment of pilonidal disease?

    Most healed, high satisfaction.Case seriesLow quality

    111 people339.2 (± 221.4) days

    78.4% of patients healed, with median healing time of 20 days and high patient satisfaction

    Who was studied
    adults with primary or recurrent pilonidal sinus disease
    What they received
    sinus laser therapy (SiLaT)
    Compared with
    none
    Main outcome
    healing of the pilonidal sinus (closure of skin openings without leakage or abscess)
    Quality
    This was a single-group case series without a comparison group, so it cannot show whether laser worked better than other treatments.
    Limitations
    No control group, single-center study, variable follow-up time, no predictive factors identified on multivariate analysis

    Taken word for word from the abstract

    • n 111 consecutive patients
    • population All adult patients, who underwent SiLaT in our department for a primary or recurrent pilonidal sinus
    • intervention sinus laser therapy (SiLaT)
    • comparator Surgery is the currently preferred approach to treatment but there is a growing interest in new minimally invasive techniques, such as sinus laser therapy (SiLaT).
    • primaryOutcome Healing was defined as the closure of cutaneous orifices and the absence of seepage or abscesses.
    • result A healing rate of 78.4% was observed, with a median time to healing of 20.0 days (15.0-30.0).
    • result Eighty-two patients (88.2%) reported being "very satisfied" with the treatment.
    • followUp The mean follow-up was 339.2 (± 221.4) days.

    J Visc Surg · PMID 38849230 · Read it on PubMed ↗

  • Basendowah et al. 2024

    Laser Ablation of Pilonidal Sinus in a Patient With Hemophilia Type A: A Case Report and Review of the Literature

    Worked in one case.Case seriesVery low qualityRelated question

    1 people2024

    the pilonidal sinus was successfully treated with laser ablation and no complications occurred

    Who was studied
    young man with hemophilia type A and recurrent pilonidal sinus
    What they received
    laser ablation of the pilonidal sinus
    Compared with
    none
    Main outcome
    successful treatment without complications
    Quality
    This is a single patient case report, so it cannot show whether laser treatment works in general.
    Limitations
    Single case report in a patient with a rare bleeding disorder, no comparison group, no long-term follow-up data given.

    Taken word for word from the abstract

    • population a young man with hemophilia A presenting with recurrent PNS
    • intervention successfully managed with laser ablation with no complications
    • comparator The mainstay of treatment for PNS is often excision of the sinus; however, recently, laser ablation has started to be commonly used.
    • primaryOutcome successfully managed with laser ablation with no complications
    • result successfully managed with laser ablation with no complications
    • n we present a case of a young man

    Cureus · PMID 38800275 · Read it on PubMed ↗

  • Paz Oliveira et al. 2024

    Minimum energy laser pilonidotomy (MELPi): a multicenter study of a novel method in pilonidal disease

    Fast healing, low pain, some recurrence.RetrospectiveLow quality

    47 people12 months

    Fast healing (median 15 days), low pain, low complication rate, but recurrence in 10% of cases

    Who was studied
    patients with pilonidal disease
    What they received
    minimal energy laser pilonidotomy (MELPi)
    Compared with
    none (single-arm, no comparison group)
    Main outcome
    healing, recurrence, pain, and complications after laser treatment
    Quality
    This was a retrospective study without a comparison group, so it can't show laser treatment is better than other options.
    Limitations
    Retrospective design, no control/comparator group, multicenter variability

    Taken word for word from the abstract

    • n We included 47 consecutive patients who underwent 50 "minimal energy pilonidotomies (MELPi)"
    • population patients who underwent 50 "minimal energy pilonidotomies (MELPi)" between 2019 and 2023 in four centers in Brazil
    • intervention minimal energy pilonidotomies (MELPi)
    • comparator This is a retrospective multicenter study.
    • primaryOutcome complications, recurrence, wound closure, pain, and return to activities were analyzed
    • result The median healing time was 15 days.
    • result The median postoperative pain was 2.
    • result recurrence occurred in 5 (10%)-in 3 patients, a second MELPi procedure was performed and was effective.

    Updates Surg · PMID 38704463 · Read it on PubMed ↗

  • Gratiashvili et al. 2024

    Efficacy of laser obliteration with limited excision of pilonidal sinus

    Faster healing, similar recurrence rates.Prospective cohortLow quality

    152 people2024

    Faster wound healing with laser (6.5 vs 14.5 weeks), similar healing rates, no significant difference in recurrence

    Who was studied
    patients with chronic pilonidal sinus disease
    What they received
    laser obliteration with limited excision (LOLE)
    Compared with
    wide excision (WE) of the pilonidal sinus
    Main outcome
    complete wound healing, recurrence, and complication rate
    Quality
    Non-randomized observational study comparing two surgical techniques, so differences could be due to other factors, not just the treatment.
    Limitations
    Not randomized; abstract does not report blinding or statistical details beyond healing time and recurrence.

    Taken word for word from the abstract

    • n A prospective, cross-sectional observational study of 152 patients with chronic pilonidal sinus disease
    • population 152 patients with chronic pilonidal sinus disease
    • intervention laser obliteration with limited excision (LOLE)
    • comparator wide excision (WE) of the pilonidal sinus
    • primaryOutcome The main evaluation criteria were complete wound healing, recurrence, and the complication rate.
    • result The duration of wound healing was significantly shorter in the LOLE group than in the WE group (6.5 ± 2.4 vs. 14.5 ± 2.6 weeks, respectively).
    • result Recurrence developed in six (7.9%) patients in the LOLE group and one (1.3%) patient in the WE group, with no significant difference.

    J Int Med Res · PMID 38530042 · Read it on PubMed ↗

  • Czarnecki et al. 2023

    Sequential, ultrasound-guided, minimally invasive pit-picking procedure with Nd:YAG laser epilation treatment for pilonidal disease

    Most patients symptom-free after treatment.Case seriesLow quality

    52 people1-year follow-up

    96% of patients were symptom-free, with only 4% experiencing relapse

    Who was studied
    adolescent patients with pilonidal disease
    What they received
    minimally invasive pit-picking procedure combined with Nd:YAG laser epilation, guided by ultrasound
    Compared with
    none
    Main outcome
    being symptom-free from pilonidal disease at follow-up
    Quality
    This is a small, retrospective study with no comparison group, so it cannot show whether the treatment works better than other options.
    Limitations
    Retrospective design, no control group, and only 52 of 147 treated patients were included in the analysis.

    Taken word for word from the abstract

    • population evaluate our treatment for pilonidal disease in adolescent patients
    • intervention uses ultrasonography, minimally invasive pit-picking, and Nd:YAG laser therapy
    • comparator We included 52 of 147 patients treated between June 2017 and December 2020.
    • primaryOutcome There were 49 symptom-free patients (96%).
    • result There were 49 symptom-free patients (96%). One patient underwent surgery in another hospital because of a recurrence and 1 had a pilonidal disease relapse (4%).
    • n A total of 52 patients were included in this study with a 1-year follow-up following the procedure.
    • followUp A total of 52 patients were included in this study with a 1-year follow-up following the procedure.

    Pol Przegl Chir · PMID 38348985 · Read it on PubMed ↗

  • Tyrväinen et al. 2024

    Comparison of laser ablation, simple excision, and flap reconstruction in the treatment of pilonidal sinus disease

    More leftover disease, fewer complications.RetrospectiveLow quality

    278 people15.4 ± 7.6 months in the laser group

    Laser had similar eventless healing rates but more residual disease and fewer complications than the other two surgical methods

    Who was studied
    patients who had surgery for pilonidal sinus disease
    What they received
    laser ablation
    Compared with
    simple excision with direct closure, or excision with flap reconstruction
    Main outcome
    eventless healing, residual disease, recurrence, complications, and re-operations
    Quality
    This was a retrospective comparison with very different follow-up times between groups, which makes the outcomes hard to compare fairly.
    Limitations
    Retrospective design; unequal and widely varying follow-up times between groups (15.4 months for laser vs 87.6 months for flap).

    Taken word for word from the abstract

    • n Among the 278 patients, 66 underwent laser treatment, 134 excision with direct closure, and 78 excision with flap closure.
    • population This retrospective study material included patients who underwent PSD surgery in the plastic surgery department of a single academic teaching hospital.
    • intervention Laser ablation has recently shown promising results in the treatment of PSD
    • comparator We aimed to compare laser ablation with two conventional treatment options: simple excision with direct closure and excision with flap reconstruction.
    • primaryOutcome Preoperative and postoperative data were compared between the groups including patient characteristics, residual disease, recurrent disease, complications, and re-operations.
    • result There was significantly more residual disease in the laser group whereas significantly more complications were found in the direct closure and flap groups.
    • followUp The follow-up time ranged from 15.4 ± 7.6 months in the laser group to 87.6 ± 29.3 months in the flap group.

    Lasers Med Sci · PMID 38291247 · Read it on PubMed ↗

  • Horesh et al. 2023

    Surgical outcomes of minimally invasive trephine surgery for pilonidal sinus disease with and without laser therapy: a comparative study

    Fewer recurrences when laser added to surgery.RetrospectiveLow quality

    221 people1-year

    adding laser therapy led to a much lower recurrence rate than surgery alone (8.2% vs 32.9%)

    Who was studied
    adults with pilonidal sinus disease
    What they received
    trephine (pit excision) surgery combined with laser therapy
    Compared with
    trephine surgery alone, without laser therapy
    Main outcome
    recurrence of the pilonidal sinus within 1 year
    Quality
    This was a retrospective, single-center study with matching to reduce bias, but it is not a randomized trial so the result could still be affected by unmeasured factors.
    Limitations
    Retrospective design, unmatched groups differed in age and surgeon experience, and the authors call for prospective studies to confirm the findings.

    Taken word for word from the abstract

    • population all adult patients with PNS who underwent trephine surgery
    • intervention trephine surgery + laser therapy
    • comparator trephine surgery alone
    • primaryOutcome the primary outcome was the 1-year recurrence rate
    • result significantly lower recurrence rate (8.2% vs. 32.9%; p < 0.001) compared to pit excision without laser therapy
    • n The study included 221 patients with PSD

    Tech Coloproctol · PMID 38093161 · Read it on PubMed ↗

  • Şahin et al. 2023

    Use of the laser in the pilonidal sinus alone or in combination with phenol

    No clear benefit of adding phenol to laser.RetrospectiveLow qualityRelated question

    46 peoplefourth month

    Laser-phenol group had slightly lower recurrence and higher healing rates than laser alone, but the difference was not statistically significant

    Who was studied
    patients with pilonidal sinus disease treated in a general surgery clinic
    What they received
    laser treatment alone or laser treatment combined with phenol
    Compared with
    laser alone versus laser plus phenol
    Main outcome
    recurrence rate and complete healing of the pilonidal sinus
    Quality
    It is a small retrospective study without randomization or a non-laser comparison group, so results carry limited weight.
    Limitations
    Retrospective design; no comparison to a non-laser treatment; small sample size; difference between groups not statistically significant.

    Taken word for word from the abstract

    • population patients with pilonidal sinus disease who were treated in the general surgery clinic of the Balikesir University Hospital between October 2019 and February 2022
    • intervention combining laser treatment with phenol in the management of pilonidal sinus
    • comparator laser treatment group and one patient (4.8%) in the laser-phenol treatment group
    • primaryOutcome Recurrence was observed in three patients (13.6%) in the laser treatment group and one patient (4.8%) in the laser-phenol treatment group after the fourth month
    • result Although not statistically significant, the laser-phenol treatment group exhibited a lower recurrence rate and a higher complete healing rate.
    • n 22 (91.7%) patients in the laser treatment group and 21 (95.5%) patients in the laser-phenol treatment group had complete healing

    Rev Assoc Med Bras (1992) · PMID 37971129 · Read it on PubMed ↗

  • Huurman et al. 2023

    Non-excisional techniques for the treatment of intergluteal pilonidal sinus disease: a systematic review

    Laser not clearly better, more recurrenceSystematic reviewLow qualityRelated question

    8,100 people2023

    Techniques that treated the inner lining (including laser) had worse recurrence rates, varying from 0 to 29%, than pit picking alone

    Who was studied
    patients with pilonidal sinus disease (a cyst/tunnel near the tailbone)
    What they received
    non-excisional techniques including pit picking with or without laser or phenol, unroofing, endoscopic treatment, and gelatin matrix application
    Compared with
    comparison between different non-excisional techniques, including with vs without treatment of the inner sinus lining, and primary vs recurrent disease
    Main outcome
    recurrence rates, healing rates, complication rates, wound healing time and return to daily activities
    Quality
    It pools very different techniques and studies of varying quality without a formal statistical meta-analysis, so the comparisons are not strong evidence.
    Limitations
    Abstract does not report study designs included (likely mostly observational), does not give statistical comparisons, and recurrence rates depend heavily on follow-up time which varied across studies.

    Taken word for word from the abstract

    • n 31 studies comprising 8100 patients were included
    • population Non-excisional techniques for pilonidal sinus disease (PSD)
    • intervention pit picking techniques with or without additional laser or phenol treatment, unroofing, endoscopic techniques and thrombin gelatin matrix application
    • comparator difference between primary and recurrent PSD
    • primaryOutcome Outcomes were recurrence rates, healing rates, complication rates, wound healing times and time taken to return to daily activities
    • result Techniques that attempt to additionally treat the inner lining of the sinus have worse recurrence rates than pit picking alone.
    • result Recurrence rates after additional laser, phenol and endoscopic techniques varied from 0 to 29%.

    Tech Coloproctol · PMID 37930579 · Read it on PubMed ↗

  • Mentessidou et al. 2024

    Outcomes of Pediatric Endoscopic Pilonidal Sinus Treatment: A Systematic Review

    No added benefit from laser hair removal.Systematic reviewLow qualityRelated question

    320 people13.5 months

    Laser hair removal (perioperative or postoperative) did not significantly change success or recurrence rates compared to other hair removal methods

    Who was studied
    Children and teens (under 18) with pilonidal sinus disease
    What they received
    Endoscopic pilonidal sinus treatment (PEPSiT), with some patients also receiving perioperative or postoperative laser hair removal
    Compared with
    Within PEPSiT: fistuloscope vs. cystoscope, and different wound care methods (regular shaving, creams, light pulse, or laser) after surgery
    Main outcome
    Treatment success (healing) and recurrence of the sinus
    Quality
    This is a pooled review of mostly small, non-randomized studies, and the laser comparison was just one of several subgroup analyses with a borderline p-value (p=0.06) that didn't reach significance.
    Limitations
    The review itself notes a lack of comparison with conventional surgical techniques, and the laser-specific finding was a secondary comparison within a broader review of an endoscopic surgical procedure, not a dedicated study of laser treatment itself.

    Taken word for word from the abstract

    • n A total of 320 patients (9 studies, 2018-2022) with a weighted mean age of 15.7 years and follow-up duration of 13.5 months were included.
    • population all studies on PEPSiT in patients younger than 18 years
    • intervention Endoscopic pilonidal sinus treatment (EPSiT) is gaining increasing popularity.
    • intervention with perioperative laser epilation
    • comparator fistuloscope vs. cystoscope
    • comparator postoperative regular shaving, depilatory creams, light pulse, or laser
    • primaryOutcome PEPSiT was successful in 290 patients (90.9%) with weighted mean time to healing of 4.1 weeks. Recurrence was reported in 29 patients (9.1%)
    • result Outcomes were not significantly altered by the use of fistuloscope versus pediatric cystoscope (p = 1.0), or with perioperative laser epilation (p = 0.06), or postoperative regular shaving, depilatory creams, light pulse, or laser (p = 0.31).
    • followUp follow-up duration of 13.5 months

    Eur J Pediatr Surg · PMID 37494954 · Read it on PubMed ↗

  • Taşkin et al. 2023

    Comparison of the effectiveness of laser and crystallized phenol in the treatment of sacrococcygeal pilonidal sinus

    Less pain, similar recurrence rates.Randomised trialLow quality

    80 people2023

    No difference in recurrence or satisfaction; laser had less pain and fewer complications but took longer

    Who was studied
    patients with sacrococcygeal pilonidal sinus disease
    What they received
    laser treatment
    Compared with
    crystallized phenol treatment
    Main outcome
    recurrence, patient satisfaction, pain, and complications
    Quality
    Small trial of 80 patients with no mention of blinding or long-term follow-up details, limiting confidence in results.
    Limitations
    Abstract does not report blinding, follow-up duration, or how recurrence was measured over time.

    Taken word for word from the abstract

    • n A total of 80 patients (40 crystallized phenol, 40 laser) were included in the study.
    • population treatment of sacrococcygeal pilonidal sinus (SPS) disease
    • intervention 40 laser
    • comparator 40 crystallized phenol
    • primaryOutcome there was no significant difference in recurrence and patient satisfaction between the groups (p > 0.05), the visual pain scale pain score and post-procedural complications were significantly lower in the laser group (p < 0.05)
    • result While there was no significant difference in recurrence and patient satisfaction between the groups (p > 0.05), the visual pain scale pain score and post-procedural complications were significantly lower in the laser group (p < 0.05).

    Cir Cir · PMID 37440707 · Read it on PubMed ↗

  • Solari et al. 2023

    Laser technology in proctological diseases: is it really the wave of the future?

    Less pain, but lower healing rate.Systematic reviewLow quality

    55 people2023

    Less pain and shorter hospital stay, but lower primary healing rate than traditional surgery

    Who was studied
    Patients with proctological conditions including pilonidal sinus disease
    What they received
    Laser treatment (SiLaT - sinus laser treatment) for pilonidal sinus disease
    Compared with
    Traditional surgical techniques for pilonidal sinus disease
    Main outcome
    Perioperative pain, hospital stay, and primary healing rate
    Quality
    This is a scoping review with no meta-analysis, highly varied studies, and no randomized trials for the pilonidal laser technique.
    Limitations
    Meta-analysis of data was not performed because of heterogeneity of study designs and outcome measures; available data on SiLaT is very limited, and no randomized trials are published to date.

    Taken word for word from the abstract

    • population SiLaT (sinus laser treatment) applied the technology used for FiLaC to the treatment of pilonidal sinus disease.
    • intervention SiLaT (sinus laser treatment)
    • comparator when compared to traditional techniques
    • primaryOutcome This technique had less perioperative pain and shorter hospital stay, but a lower primary healing rate when compared to traditional techniques.
    • result This technique had less perioperative pain and shorter hospital stay, but a lower primary healing rate when compared to traditional techniques.
    • n 55 studies were included for the final revision.
    • limitations Meta-analysis of data was not performed because of heterogeneity of study designs and outcome measures.
    • limitations Available data is very limited, and no randomized trials are published to date.

    Updates Surg · PMID 37438655 · Read it on PubMed ↗

  • Bilgin et al. 2023

    Short- and mid-term results of diode laser treatment in pilonidal sinus disease and the role of endoscopic camera use on outcomes

    Good recovery and low recurrence with laser.RetrospectiveLow quality

    106 peopleminimum of 1 year

    87.8% completely recovered, mean recovery 27.4 days, 11.0% recurrence, 99.0% satisfaction; camera use made no difference to outcomes

    Who was studied
    patients with pilonidal sinus disease
    What they received
    diode laser treatment (1470-nm), with or without endoscopic camera use
    Compared with
    use of endoscopic camera versus no camera use during laser treatment
    Main outcome
    postoperative pain, recovery time, complications, patient satisfaction, and recurrence
    Quality
    This was a retrospective study without a comparison group to standard surgery, so it cannot show laser works better than other treatments.
    Limitations
    Data were analyzed retrospectively

    Taken word for word from the abstract

    • n A total of 106 patients with PSD who underwent laser treatment
    • population 106 patients with PSD who underwent laser treatment between November 2017 and September 2021
    • intervention All patients were treated with a 1470-nm diode laser.
    • comparator Endoscopic camera was used in 73 patients and results of these were compared with those in whom camera was not used.
    • primaryOutcome we analyze the short- and mid-term results after laser treatment and the effect of endoscopic camera use on outcomes
    • result Eighty-six (87.8%) patients completely recovered and the mean complete recovery time was 27.4 ± 15.9 days. The patient satisfaction rate was 99.0%. The recurrence rate was 11.0%.
    • result Use of an endoscopic camera had no effect on postoperative pain, complete recovery, complications, patient satisfaction, and recurrence
    • followUp Follow-up period was determined as a minimum of 1 year.
    • limitations Data were analyzed retrospectively.

    Tech Coloproctol · PMID 37356014 · Read it on PubMed ↗

  • Spindler et al. 2023

    [Pilonidal disease: The revolution in minimally invasive surgery]

    Promising early results, but evidence still weak.Narrative reviewVery low qualityRelated question

    size not given1 year

    Failure rates of less than 10% at 1 year, with few and minor complications

    Who was studied
    People with pilonidal disease (a common skin condition near the tailbone)
    What they received
    Minimally invasive techniques, including endoscopic and laser treatment
    Compared with
    Standard surgical excision (lay-open excision, primary repair, or flap procedures)
    Main outcome
    Failure/recurrence rate and complications after treatment
    Quality
    This is a narrative review summarizing other studies, not new controlled data, and the authors themselves say better quality studies with longer follow-up are needed.
    Limitations
    Abstract groups endoscopic and laser techniques together rather than reporting laser results alone, and explicitly states results need confirmation by better studies with longer follow-up.

    Taken word for word from the abstract

    • population Pilonidal disease is a common suppurative condition and affects 0.7% of the population.
    • intervention Endoscopic and laser treatment of pilonidal disease have shown promising results
    • comparator Surgical excision is the standard treatment.
    • primaryOutcome failure rates of less than 10% at 1 year, few complications and low morbidity
    • result Endoscopic and laser treatment of pilonidal disease have shown promising results, with failure rates of less than 10% at 1 year, few complications and low morbidity.

    Rev Prat · PMID 37289117 · Read it on PubMed ↗

  • Gil et al. 2023

    Management of Pilonidal Disease: A Review

    No specific result reported for laser.Narrative reviewLow qualityRelated question

    size not given2023

    abstract does not report specific outcome data for laser treatment; it is only listed as one of several options

    Who was studied
    people with pilonidal disease (a skin condition near the tailbone)
    What they received
    laser or intense pulse light hair removal, used alone or alongside other treatments
    Compared with
    other treatments for pilonidal disease, including surgery and conservative care
    Main outcome
    disease recurrence and treatment-related complications
    Quality
    this is a general narrative review that does not present actual study results or data comparing laser treatment to other options
    Limitations
    the abstract itself states the overall evidence is limited by study quality, inconsistent disease definitions, and variable outcome reporting across studies

    Taken word for word from the abstract

    • intervention Epilation techniques using both laser and intense pulse light therapy are also used as primary and adjunct treatment modalities.
    • population the management of pilonidal disease
    • result Overall, the current evidence supporting the different treatment options is limited by study quality with inconsistent characterization of disease severity and use of variable definitions and reporting of treatment-associated outcomes across studies.
    • primaryOutcome high rates of recurrence and treatment-associated morbidity
    • comparator primary midline closure, primary off-midline closure techniques (ie, Karydakis flap, Limberg flap, Bascom cleft lift), and healing by secondary intention

    JAMA Surg · PMID 37256592 · Read it on PubMed ↗

  • Ganduboina et al. 2023

    Laser ablation: a unique and beneficial therapeutic option for pilonidal sinus? And the potential for further innovation-a review

    Better healing, fewer complications with laserSystematic reviewLow quality

    size not given2023

    Laser ablation showed higher healing rates, lower recurrence, less post-op morbidity, and higher patient satisfaction compared to conventional surgery

    Who was studied
    People with pilonidal sinus disease
    What they received
    Laser ablation techniques (e.g., SiLaC, SiLaT, PiLaT, LEPSiT) using diode or Nd:YAG lasers
    Compared with
    Conventional surgical methods for pilonidal sinus disease
    Main outcome
    Healing rate, recurrence, complications, and patient satisfaction
    Quality
    This is a literature review without pooled statistics or formal quality assessment, so the findings are less reliable than a controlled trial.
    Limitations
    The abstract does not describe study quality, bias assessment, or statistical pooling, and calls for long-term prospective comparative studies.

    Taken word for word from the abstract

    • population pilonidal sinus disease
    • intervention Techniques like sinus laser-assisted closure (SiLaC), sinus laser therapy (SiLaT), pilonidal sinus laser treatment (PiLaT), and laser-assisted endoscopic pilonidal sinus treatment (LEPSiT) were included and reviewed.
    • comparator effectiveness compared to other conventional methods
    • primaryOutcome The highest healing rate was observed with Nd:YAG laser and the SiLaT technique. Recurrence was low, particularly in patients who underwent multiple procedures.
    • result laser ablation procedures showed lower morbidity and post-op complications. Patient satisfaction was higher, and the overall cost was found to be lower with minimally invasive techniques.

    Lasers Med Sci · PMID 37204472 · Read it on PubMed ↗

  • Ersavas et al. 2023

    Endoscopic pilonidal sinus treatment (EPSIT) versus sinus laser therapy (SiLaT) for sacrococcygeal pilonidal sinus

    Similar healing, more pain relief needed with laserRetrospectiveLow quality

    73 people2023

    Wound healing time and return to activity were similar between groups; SiLaT patients needed analgesics for longer; no significant difference in complications or recurrence

    Who was studied
    patients with pilonidal sinus (sacrococcygeal pilonidal sinus disease)
    What they received
    sinus laser therapy (SiLaT)
    Compared with
    endoscopic pilonidal sinus treatment (EPSIT)
    Main outcome
    complications, wound healing time, return to activity, and recurrence
    Quality
    This was a small retrospective study comparing two surgical techniques without randomization, so it cannot reliably show which treatment is better.
    Limitations
    Retrospective design, small sample size, no randomization mentioned

    Taken word for word from the abstract

    • n Seventy-three patients with pilonidal sinus who had undergone EPSIT or SiLaT within 2 years were evaluated retrospectively.
    • population patients with pilonidal sinus
    • intervention sinus laser therapy (SiLaT)
    • comparator endoscopic pilonidal sinus treatment (EPSIT)
    • primaryOutcome Data of patients' demographics, complications and postoperative course were collected and compared between the two groups.
    • result The duration of analgesic use was significantly lower in the EPSIT group compared to the SiLaT group
    • result The mean postoperative time of total wound healing was similar for both groups:
    • result There was no significant difference in the average time of return to total daily activity
    • result There were no significant differences between the groups regarding late postoperative complications (recurrence: 7).

    Wideochir Inne Tech Maloinwazyjne · PMID 37064557 · Read it on PubMed ↗

  • Salimi-Jazi et al. 2023

    Increasing Amount of Hair Reduction using Laser Correlates with Lower Probability of Recurrence in Patients with Pilonidal Disease

    More laser hair removal, fewer recurrences.Case seriesLow quality

    198 people217 days

    greater hair reduction from laser was linked to lower recurrence; overall recurrence rate was 6%

    Who was studied
    patients with pilonidal disease undergoing laser hair removal
    What they received
    laser epilation (hair removal)
    Compared with
    different amounts of hair reduction achieved (within same group, no control group)
    Main outcome
    recurrence of pilonidal disease
    Quality
    This is a single-group study without a comparison group, so it cannot prove laser itself caused fewer recurrences.
    Limitations
    No control group, retrospective-style single arm design, Level IV evidence

    Taken word for word from the abstract

    • n 198 PD patients had mean age 18.1 ± 3.6 years.
    • population PD patients who underwent laser epilation (LE)
    • intervention laser epilation (LE)
    • comparator more hair reduction achieved using laser could correlate with lower chance of PD recurrence
    • primaryOutcome lower chance of PD recurrence
    • result Probability of recurrence after 20%, 50%, 75% hair reduction was decreased by 50%, 78%, 100%, respectively.
    • result PD recurrence rate was 6%.
    • followUp Median follow-up was 217 days.

    J Pediatr Surg · PMID 36934004 · Read it on PubMed ↗

  • Horesh et al. 2023

    Outcomes of Laser-Assisted Closure (SiLaC) Surgery for Chronic Pilonidal Sinus Disease

    Most healed completely after laser surgery.RetrospectiveLow quality

    92 people2023

    81.3% of patients achieved complete healing, with about 10% having recurrent or nonhealing disease

    Who was studied
    patients with chronic pilonidal sinus disease
    What they received
    laser-assisted closure (SiLaC) surgery for pilonidal sinus
    Compared with
    none - single group, no comparison treatment
    Main outcome
    complete healing rate after surgery
    Quality
    This was a retrospective, single-arm study without a comparison group, so it can't show whether laser treatment works better than other options.
    Limitations
    Retrospective design, no control group, one patient lost to follow-up, and small single-center sample.

    Taken word for word from the abstract

    • n A total of 92 patients (86 males, 93.4%) underwent SiLaC surgery for pilonidal sinus disease during the study period.
    • population all patients who underwent minimally invasive surgery combined with laser therapy for PNS
    • intervention sinus laser-assisted closure (SiLaC) of pilonidal disease
    • comparator A retrospective analysis of a prospective database of all patients who underwent minimally invasive surgery combined with laser therapy for PNS
    • primaryOutcome The primary outcome was complete healing rate, standing at 81.3% (74/91 patients).
    • result Recurrent/nonhealing disease was seen in 9 patients (9.9%), requiring reoperation in 7 patients (8.4%).

    J Laparoendosc Adv Surg Tech A · PMID 36888964 · Read it on PubMed ↗

  • Williams et al. 2023

    Laser Ablation of Pilonidal Sinus Disease: A Pilot Study

    Mostly healed, low pain, high satisfaction.Case seriesVery low quality

    25 people6 mo

    most patients had little pain, quick return to activity, high satisfaction, and most were healed by 6 months

    Who was studied
    adults and children with pilonidal sinus disease
    What they received
    laser ablation of the pilonidal sinus tract
    Compared with
    none (no comparison group)
    Main outcome
    safety and feasibility of the procedure, including pain, healing, and satisfaction
    Quality
    this is a small pilot study of 25 patients with no comparison group, so it cannot show whether laser works better than other treatments.
    Limitations
    small pilot study, no control group, short follow-up, not all patients healed

    Taken word for word from the abstract

    • n We performed 27 laser ablation procedures in 25 patients
    • population We performed laser ablation in adults and pediatric patients.
    • intervention Laser ablation provides a minimally invasive means of obliterating pilonidal sinus tracts
    • comparator We aimed to determine the safety and feasibility of laser ablation of pilonidal sinus disease.
    • primaryOutcome We aimed to determine the safety and feasibility of laser ablation of pilonidal sinus disease.
    • result Eighty percent of patients reported either no pain or mild pain at the 2-week postoperative visit.
    • result Eighty-eight percent of patients reported being satisfied or very satisfied with the procedure at their most recent follow-up (median, 6 mo).
    • result Eighty-two percent of patients were healed at 6 months.

    Dis Colon Rectum · PMID 36877001 · Read it on PubMed ↗

  • De Decker et al. 2023

    Does minimally invasive laser-assisted treatment of pilonidal sinus disease live up to its expectations: a multi-center study with 226 patients

    Mostly works but imperfect healing.RetrospectiveLow quality

    226 people129 days [7-1120]

    85.4% overall healing after one or more laser procedures, but 12.8% needed secondary surgery

    Who was studied
    patients with pilonidal sinus disease treated at three hospitals
    What they received
    laser-assisted treatment of pilonidal sinus
    Main outcome
    overall wound healing after one or more laser procedures
    Quality
    This was a retrospective study without a comparison group, so results may not be reliable and could involve bias.
    Limitations
    Retrospective design, no control group, variable follow-up time, multi-center variability

    Taken word for word from the abstract

    • n A total of 226 patients were included
    • population all patients undergoing laser-assisted treatment of pilonidal sinus disease at three Belgian hospitals between January 2017 and December 2021
    • intervention laser-assisted treatment of pilonidal sinus disease
    • primaryOutcome The primary endpoint was overall wound healing after one or more laser assisted procedures.
    • result The healing rate after one laser procedure was 78.8%. Some of these patients were healed by a second or third procedure adding up to an overall healing rate of 85.4% after one or more laser procedures.
    • result For 29 patients (12.8%), laser-assisted treatment was insufficient, leading to a secondary operation (drainage, excision, or flap).
    • followUp mean follow-up time of 129 days [7-1120]

    Int J Colorectal Dis · PMID 36763170 · Read it on PubMed ↗

  • Liagkos et al. 2023

    Minimally invasive treatment of pilonidal sinus using the new Infinite Ring Fiber. A case series

    All treated successfully, no complications.Case seriesVery low quality

    13 people2023

    all patients were successfully treated with no complications or relapse during follow-up

    Who was studied
    patients with pilonidal cyst with a small fistula opening
    What they received
    laser treatment (NeoV1470 laser with Infinite Ring Fiber) under local anesthesia
    Compared with
    none
    Main outcome
    successful treatment without complications or disease recurrence
    Quality
    This is a tiny uncontrolled case series of only 13 patients, so it cannot reliably show whether the laser works better than other treatments.
    Limitations
    small sample size, no comparator group, follow-up duration not specified

    Taken word for word from the abstract

    • n consisting of 13 patients
    • population patients with pilonidal cyst, which were treated with NeoV1470 Laser System
    • intervention treated with NeoV1470 Laser System using Infinite Ring Fiber 600 microns (Mm)
    • comparator RESULTS: All the patients had successful treatment.
    • primaryOutcome None of the patients treated with the particular fiber had any complications or relapsed disease during the follow up period.
    • result All the patients had successful treatment. None of the patients treated with the particular fiber had any complications or relapsed disease during the follow up period.

    Ann Ital Chir · PMID 36408956 · Read it on PubMed ↗

  • Zubaidi et al. 2022

    Outcomes of Sinus Laser Therapy in Sacrococcygeal Pilonidal Sinus Disease: A Single-Center Experience

    Mostly healed, but recurrence in a quarter.RetrospectiveLow quality

    41 peopleat least six months

    Most wounds healed without complications, but about a quarter of patients had the cyst come back

    Who was studied
    patients with sacrococcygeal pilonidal sinus disease (primary or recurrent)
    What they received
    sinus laser therapy (SiLaT)
    Compared with
    none (single-arm, no comparison group)
    Main outcome
    wound healing outcomes, recurrence, pain, and patient satisfaction
    Quality
    This is a small, retrospective single-center study with no comparison group, so it cannot show whether laser works better than other treatments.
    Limitations
    Retrospective design, no control group, small sample size.

    Taken word for word from the abstract

    • n Forty-one participants (37 males (90.2%) and four females (9.8%)) were included.
    • population patients with SPND at a tertiary center
    • intervention sinus laser therapy (SiLaT)
    • comparator A retrospective study was conducted to evaluate and report the healing outcome of the application of SiLaT on patients with SPND
    • primaryOutcome The mean duration of hospital stays, resumption of regular activity, and complete wound healing by secondary intention were 30±21.5 hours, 18.4±14.3 days, and 6.5±6.6 weeks, respectively.
    • result Around 95.1% of wounds healed without complications. The overall recurrence rate was 24.4%
    • followUp followed up for at least six months

    Cureus · PMID 36304355 · Read it on PubMed ↗

  • Check et al. 2022

    Resolution of Mild Pilonidal Disease in Adolescents Without Resection

    Resolved without surgery in most patients.Case seriesLow quality

    102 people30 ± 19 weeks

    77 of 78 patients who continued care had their pilonidal disease resolve without surgery

    Who was studied
    adolescents and young adults with mild pilonidal disease
    What they received
    improved hygiene, pit excision under local anesthesia, and laser hair removal
    Compared with
    no comparison group; compared to traditional surgical resection in background
    Main outcome
    resolution of pilonidal disease
    Quality
    This was a single-group case series without a comparison group, and nearly a quarter of patients were lost to follow-up.
    Limitations
    Twenty-four of 102 patients were lost to follow up; no control group for comparison.

    Taken word for word from the abstract

    • n One hundred two patients presented
    • population consecutive new patients presenting to an outpatient pilonidal care clinic with mild disease
    • intervention improved hygiene to limit debris in the gluteal crease, excision of midline pilonidal pits under local anesthesia to prevent intrusion of debris with drainage of any nidus present, and laser ablation of midline follicles to prevent new pits from forming
    • comparator nidus resection is often recommended, even for patients with mild pilonidal disease, despite significant postoperative morbidity
    • primaryOutcome 77 of the 78 who continued care had resolution of their pilonidal disease
    • result 77 of the 78 who continued care had resolution of their pilonidal disease after a mean of 3 ± 2.5 laser epilations and 1.3 ± 1 pit excisions during 4 ± 2 clinic visits over a treatment duration of 30 ± 19 weeks

    J Am Coll Surg · PMID 36102566 · Read it on PubMed ↗

  • Dönmez et al. 2022

    Evaluation of the Early Outcomes of Laser-Endoscopic Pilonidal Sinus Treatment Combination and Comparison With the Combination of Cautery-Phenol-Endoscopic Pilonidal Sinus Treatment

    Faster surgery, less pain, similar healing.RetrospectiveLow quality

    42 people2022

    No significant difference in return to daily life, pain-free walking, recovery time, or recurrence, but shorter operation time and less pain on day of surgery with laser combination

    Who was studied
    patients over 16 with pilonidal sinus disease, primary or recurrent, without active infection
    What they received
    laser combined with endoscopic pilonidal sinus treatment
    Compared with
    cautery-phenol combined with endoscopic pilonidal sinus treatment
    Main outcome
    time to return to daily life, pain-free walking, recovery time, and recurrence
    Quality
    Small retrospective study comparing two groups with short follow-up, so results may not be reliable or lasting.
    Limitations
    Retrospective design, small sample size, and short follow-up period; authors state larger studies with longer follow-up are needed.

    Taken word for word from the abstract

    • n retrospective study of 42 patients with pilonidal sinus disease
    • population Both primary and recurrent patients over 16 years of age without active infection were included.
    • intervention 26 participants in group one were treated with the laser-endoscopic pilonidal sinus treatment combination
    • comparator the remaining 16 in group two were treated with the cautery-phenol-endoscopic pilonidal sinus treatment combination
    • primaryOutcome There was no significant difference between the two groups with regards to the time to return to daily life, pain-free walking, recovery time, and recurrence.
    • result However, in group one, the operation time was statistically shorter (p = 0.02), and the rate of sitting on the toilet without pain on the day of surgery was significantly higher (p = 0.029).

    Cureus · PMID 35989794 · Read it on PubMed ↗

  • Collings et al. 2022

    Updates on the Management of Pilonidal Disease

    No specific results reported.Narrative reviewVery low qualityRelated question

    size not given2022

    not clearly reported

    Who was studied
    children and teens with pilonidal cysts
    What they received
    laser hair removal and minimally invasive treatments
    Compared with
    other surgical options
    Main outcome
    management of pilonidal disease
    Quality
    This is a general narrative review that only mentions laser epilation as one option without reporting specific results or data.
    Limitations
    No specific data, outcomes, or comparative results are given for laser treatment; it's a broad overview article.

    Taken word for word from the abstract

    • population management of pilonidal disease in the pediatric population
    • intervention use of laser epilation
    • comparator minimally invasive surgical options are highlighted with a brief review of more invasive surgical options for refractory disease
    • primaryOutcome This article reviews the current practices and evidence on the management of pilonidal disease
    • result Medical management, use of laser epilation, and minimally invasive surgical options are highlighted

    Adv Pediatr · PMID 35985713 · Read it on PubMed ↗

  • Salimi-Jazi et al. 2022

    Burden of pilonidal disease and improvement in quality of life after treatment in adolescents

    Quality of life improved after laser treatment.Case seriesLow quality

    101 people2022

    Quality of life significantly improved after treatment across all measured categories

    Who was studied
    Adolescents with pilonidal disease
    What they received
    Minimally invasive treatment with laser hair removal, sometimes combined with trephination
    Compared with
    Same patients' condition before treatment (no separate control group)
    Main outcome
    Quality of life, including daily activities, sports, school/work attendance, and socializing
    Quality
    This study only compared patients before and after treatment with no control group, so it can't rule out other reasons for improvement.
    Limitations
    No control group, 30 patients excluded for incomplete data, and before/after design without randomization

    Taken word for word from the abstract

    • n 101 (51 male, 50 female) patients were included.
    • population Pilonidal Disease (PD) affects adolescents
    • intervention 131 PD patients underwent MIT (laser epilation ± trephination) from 2019 to 2021.
    • comparator Before and after MIT, patients received QOL questionnaire
    • primaryOutcome QOL questionnaire consisting of four categories: daily activities, sports participation, school/work attendance, and socializing
    • result after MIT, only 7%, 8%, 2%, and 4% were affected (p < 0.01)

    Pediatr Surg Int · PMID 35842877 · Read it on PubMed ↗

  • Fernandes et al. 2022

    Minimally invasive treatment of pilonidal sinus disease in a paediatric population: comparison of two techniques

    Laser healed slower, more complications.RetrospectiveLow quality

    106 people2022

    Laser ablation group had slower healing, more early healing failures, and more complications than sinusectomy, but similar recurrence rates

    Who was studied
    children and teens with pilonidal sinus disease
    What they received
    pit-picking plus laser ablation
    Compared with
    sinusectomy (surgical removal of sinus tract)
    Main outcome
    healing time, recurrence, and complication rates
    Quality
    This was a retrospective, non-randomized comparison, so differences could be due to factors other than the treatment itself.
    Limitations
    Retrospective review without randomization, so treatment groups may not be fully comparable.

    Taken word for word from the abstract

    • population All cases of paediatric PD treated by PPL and SE at our center between August 2018 and August 2020 were retrospectively reviewed.
    • intervention pit-picking plus laser ablation (PPL)
    • comparator sinusectomy (SE)
    • primaryOutcome Median healing time was significantly lower in SE group (20 days), comparing to PPL (30 days) (p = 0.002).
    • result Early healing failure occurred more frequently in the PPL group (p = 0.003). Recurrence rate was similar between groups - PPL 17% versus SE 16% (p = 0.89). Overall complication rate was 9% and was significantly higher in PPL (p = 0.03).
    • n One-hundred and six patients were included

    ANZ J Surg · PMID 35678224 · Read it on PubMed ↗

  • Johnson et al. 2023

    Pilonidal sinus laser-assisted closure (PiLAC) - a low-morbidity alternative to excision with excellent long-term outcomes

    Most healed, low recurrence.Case seriesLow quality

    35 peoplemean 407 days (range 67-887 days)

    25 of 28 patients followed long-term (89.3%) had healed with no recurrence

    Who was studied
    adults with primary or recurrent pilonidal sinus disease having day-case surgery
    What they received
    laser-assisted closure of the pilonidal sinus (PiLAC)
    Compared with
    none - single-arm study, no direct comparison group
    Main outcome
    whether the sinus healed completely or came back (recurrence) on long-term follow-up
    Quality
    This was a small single-centre case series without a comparison group, so it can't prove laser treatment is better than surgery, only that most patients healed.
    Limitations
    Small sample size, no control/comparator arm, mixed prospective/retrospective data collection, and variable follow-up duration.

    Taken word for word from the abstract

    • n A total of 35 patients underwent PiLAC
    • population All patients undergoing PiLAC as a day-case between April 2016 and July 2019 were included.
    • intervention Pilonidal sinus Laser-Assisted Closure (PiLAC)
    • comparator We recommend it as an alternative to surgical excision.
    • primaryOutcome Patients were followed up in a nurse-led clinic until complete healing or recurrence.
    • result 25/28 patients (89.3%) had healed with no recurrence on long-term follow-up.
    • followUp mean 407 days (range 67-887 days)

    Ann R Coll Surg Engl · PMID 35446708 · Read it on PubMed ↗

  • Gurbanov et al. 2021

    Management of sacrococcygeal pilonidal sinus disease in children: A survey study in Turkey

    Survey of surgeon opinions, not outcomes.Case seriesVery low qualityRelated question

    88 people2021

    85.2% of surgeons recommended laser epilation to patients, but no patient outcomes or efficacy data were reported

    Who was studied
    Turkish pediatric surgeons treating children with pilonidal sinus disease
    What they received
    Laser epilation recommended to patients
    Compared with
    Surgical excision versus minimally invasive procedures
    Main outcome
    Surgeons' preferred management practices and opinions on pilonidal sinus disease
    Quality
    This is a survey of surgeons' opinions and practice patterns, not a study measuring actual patient outcomes from laser treatment.
    Limitations
    Low response rate (19%), survey of physician opinions rather than clinical outcomes, no randomization or comparison of actual treatment results.

    Taken word for word from the abstract

    • n Nineteen percent (88) of the members responded.
    • population This study aims to evaluate clinical approach of Turkish pediatric surgeons to children with pilonidal sinus disease.
    • intervention Vast majority of the pediatric surgeons recommended laser epilation (%85.2) and slimming (59.1%) to patients.
    • comparator Surgical excision methods were preferred more than minimally invasive procedures (102 to 46).
    • primaryOutcome The participants were asked pre-selected and checkbox questions.
    • result Vast majority of the pediatric surgeons recommended laser epilation (%85.2) and slimming (59.1%) to patients.

    Turk J Surg · PMID 35112061 · Read it on PubMed ↗

  • Gulcu et al. 2022

    Endoscopic pilonidal sinus treatment vs. laser-assisted endoscopic pilonidal sinus treatment: short-term results from a retrospective case-matched study

    Similar healing, less pain with laser.RetrospectiveLow quality

    96 people9 months

    Wound healing rates (LEPSIT; 95.8% vs. EPSIT; 93%; p = 0.99) were similar in both groups.

    Who was studied
    patients who underwent LEPSIT and EPSIT procedures for PSD
    What they received
    laser-assisted EPSIT (LEPSIT)
    Compared with
    endoscopic pilonidal sinus treatment (EPSIT)
    Main outcome
    The primary endpoint was complete wound healing
    Quality
    This was a small retrospective case-matched study with short follow-up, so it can't prove laser treatment truly works better.
    Limitations
    Retrospective design, small laser group (n=24), short follow-up (3-15 months), no randomization.

    Taken word for word from the abstract

    • n Twenty-four LEPSIT patients were matched to 72 EPSIT patients.
    • population patients who underwent LEPSIT and EPSIT procedures for PSD
    • intervention laser-assisted EPSIT (LEPSIT)
    • comparator endoscopic pilonidal sinus treatment (EPSIT)
    • primaryOutcome The primary endpoint was complete wound healing
    • result Wound healing rates (LEPSIT; 95.8% vs. EPSIT; 93%; p = 0.99) were similar in both groups.
    • followUp The median follow-up time was 9 months (range 3-15 months).

    Tech Coloproctol · PMID 35025023 · Read it on PubMed ↗

  • Sluckin et al. 2022

    Sinus laser-assisted closure (SiLaC®) for pilonidal disease: results of a multicentre cohort study

    Often needed repeat laser treatments to work.Prospective cohortLow quality

    311 peoplemedian follow-up of 10 months (range 1-52 months)

    After one treatment 26% had recurrence and 7% had incomplete wound closure (66% initial success); success rose to 92% after two treatments and 98% after three treatments

    Who was studied
    patients with pilonidal disease
    What they received
    sinus laser-assisted closure (SiLaC®) treatment
    Compared with
    no comparator; before/after single-arm outcomes across repeated treatments
    Main outcome
    recurrence of pilonidal disease after treatment
    Quality
    This was a single-arm, partly retrospective cohort without a comparison group, so it can show how the laser treatment performs but cannot prove it works better than other options.
    Limitations
    Partial retrospective data collection and no control group for comparison; follow-up time varied widely between patients.

    Taken word for word from the abstract

    • population patients with PD treated with SiLaC®
    • intervention sinus laser-assisted closure (SiLaC®)
    • comparator A multicentre cohort study with a prospective design and partial retrospective data collection
    • primaryOutcome The primary outcome was recurrence.
    • result The recurrence rate after one SiLaC® treatment was 26% with 7% experiencing incomplete wound closure, resulting in an initial success rate of 66% after one SiLaC® procedure. This increased to 92% and 98% after two and three SiLaC® procedures, respectively.
    • n A total of 311 patients were included with a median follow-up of 10 months (range 1-52 months).
    • followUp median follow-up of 10 months (range 1-52 months)

    Tech Coloproctol · PMID 34993686 · Read it on PubMed ↗

  • Spindler et al. 2022

    Extensive suppuration and being overweight are factors associated with the failure of laser treatment for pilonidal disease: lessons from the first French retrospective cohort

    Cured about 7 in 10 patients.RetrospectiveLow quality

    29 people370.3 days

    About 69% of patients were cured, with 2 early failures and 7 recurrences

    Who was studied
    adults with pilonidal disease
    What they received
    laser treatment of the pilonidal sinus (SiLaT)
    Compared with
    no comparison group reported
    Main outcome
    closure of skin openings with no ongoing discharge or abscess
    Quality
    This was a small, single-group study without a comparison treatment, so it can't show laser is better than other options.
    Limitations
    Single-center retrospective design with no control group and only 29 patients.

    Taken word for word from the abstract

    • n We included 29 consecutive patients (22 males)
    • population All adult patients treated with SiLaT in our department
    • intervention sinus laser therapy (SiLaT) for the treatment of pilonidal disease
    • comparator All adult patients treated with SiLaT in our department between June 1, 2018, and August 23, 2019, were included in the study.
    • primaryOutcome Success was defined as the closure of cutaneous orifices and the absence of discharge or abscesses.
    • result We observed 2 primary failures (6.9%) and 7 recurrences (24.1%). Ultimately, 20 patients were considered to have been cured (69%).
    • followUp The mean follow-up was 370.3 days (± 165.8 days).

    Tech Coloproctol · PMID 34855026 · Read it on PubMed ↗

  • Romic et al. 2022

    Laser treatment of pilonidal disease: a systematic review

    High healing, low recurrence with laser.Systematic reviewLow quality

    971 people12 (range 7-25) months

    94.4% achieved primary healing with a 3.8% weighted mean recurrence rate and 10% minor complication rate

    Who was studied
    patients with chronic pilonidal disease
    What they received
    radially emitting laser treatment
    Compared with
    none (no comparator group across pooled studies)
    Main outcome
    primary healing and recurrence rate after laser treatment
    Quality
    This pooled uncontrolled case series data from only 10 studies without a comparison group or randomization, so it cannot show laser is better than other treatments.
    Limitations
    No randomized controlled trials included, high heterogeneity in complication rates, results limited to mild chronic disease, lack of standardized severity classification and outcome reporting.

    Taken word for word from the abstract

    • population studies reporting laser treatment of chronic PD
    • intervention The use of radially emitting laser in the treatment of chronic PD
    • comparator A systematic review was conducted after PubMed, Scopus, Embase, Web of Science, and the Cochrane database search for studies reporting laser treatment of chronic PD.
    • primaryOutcome 917 (94.4%) patients achieved primary healing with a weighted mean recurrence rate of 3.8%
    • result 917 (94.4%) patients achieved primary healing with a weighted mean recurrence rate of 3.8%. The weighted mean complication rate was 10% (95% CI 5.7-14.3%, I2 = 82.28, p < 0.001), and all were minor.
    • n Ten of 87 studies were eligible for the review, including 971 patients.
    • followUp With a median follow-up of 12 (range 7-25) months

    Lasers Med Sci · PMID 34291332 · Read it on PubMed ↗

  • Papagiannopoulos et al. 2021

    US Guided Si.La.D. A new technique for minimally invasive pilonidal disease treatment, using ultrasound guided laser ablation

    Safe with no major complications.Case seriesVery low quality

    17 people2021

    no significant complications were recorded

    Who was studied
    people with pilonidal sinus disease
    What they received
    ultrasound-guided laser destruction of the pilonidal sinus tract (US guided Si.La.D.)
    Compared with
    none reported
    Main outcome
    safety and complications of the procedure
    Quality
    This is a small uncontrolled case series of only 17 patients with no comparison group, so it cannot show whether laser works better than other treatments.
    Limitations
    No control group, small sample size, no long-term outcome or recurrence data reported.

    Taken word for word from the abstract

    • n 17 patients (12 men, 5 women) were operated with US guided laser destruction
    • population 17 patients (12 men, 5 women) were operated with US guided laser destruction - US guided Si.La.D.
    • intervention Laser destruction of the pathological tissue (cavity, sinus) was performed using a 400 μ radial optical fiber, connected and locked to a radiopaque biopsy needle 14 G, using a 12 MHz linear probe, to introduce and real-time echo guide the fiber in order to achieve laser ablation
    • comparator Methods: 17 patients (12 men, 5 women) were operated with US guided laser destruction - US guided Si.La.D.
    • primaryOutcome No significant complications were recorded.
    • result No significant complications were recorded.

    Expert Rev Med Devices · PMID 34124979 · Read it on PubMed ↗

  • Abdelnaby et al. 2021

    Sinus laser therapy versus sinus lay open in the management of sacrococcygeal pilonidal disease

    More recurrence but faster healing with laser.RetrospectiveLow quality

    139 people12 months

    Lay open had fewer recurrences and was faster to perform, but laser therapy healed quicker, had better cosmetic results and higher quality of life scores; complication rates were similar

    Who was studied
    patients with sacrococcygeal pilonidal disease
    What they received
    sinus laser therapy (SiLaT)
    Compared with
    sinus lay open surgery
    Main outcome
    complete healing at 12 months, time to healing, complications, operation time, and quality of life
    Quality
    This was a retrospective, non-randomized comparison, so differences between groups could be due to factors other than the treatment itself.
    Limitations
    Retrospective design, not randomized, so selection bias may affect comparisons between groups.

    Taken word for word from the abstract

    • n A total of 139 patients with a mean age of 25 years were included to the study.
    • population Patients with SPND who were treated with SiLaT or lay open were retrospectively reviewed.
    • intervention sinus laser therapy (SiLaT)
    • comparator sinus lay open
    • primaryOutcome The main outcome measures were the success of surgery in terms of complete healing at 12 months postoperatively, time to complete healing, complications, operation time and quality of life (QoL).
    • result Six patients experienced recurrence after SiLaT while there was no recorded recurrence after the lay open technique (P = 0.007). Sinus lay open had a shorter operation time than SiLaT (P < 0.0001). On the other hand, SiLaT was followed by a shorter healing time, lower incidence of delayed wound healing, better cosmetic outcome, and higher QoL scores compared to the lay open group. The complication rates were comparable between the two groups.

    Colorectal Dis · PMID 34042233 · Read it on PubMed ↗

  • Esposito et al. 2021

    Pediatric endoscopic pilonidal sinus treatment (PEPSiT): what we learned after a 3-year experience in the pediatric population

    High healing, low recurrence with combined surgery.RetrospectiveVery low qualityRelated question

    152 people12.8 months

    95.4% of patients healed completely within 8 weeks, with a 4.6% recurrence rate and low complication rates

    Who was studied
    children and teenagers with pilonidal sinus disease
    What they received
    endoscopic pilonidal sinus surgery combined with laser therapy before and after surgery
    Main outcome
    complete healing within 8 weeks, healing time, complications and recurrence
    Quality
    This is a retrospective case series with no comparison group, so it cannot show whether the laser itself made any difference.
    Limitations
    Retrospective design, no control group, and laser therapy was combined with endoscopic surgery rather than tested alone.

    Taken word for word from the abstract

    • n A total of 152 patients (98 boys) were included.
    • population All patients < 18 years, with primary or recurrent pilonidal sinus disease (PSD), undergoing PEPSiT
    • intervention All patients received pre-operative laser therapy, PEPSiT and post-operative dressing and laser therapy.
    • primaryOutcome Success rate, healing rate/time, post-operative management, short- and long-term outcome and patient satisfaction were assessed.
    • result Complete healing in 8 weeks was achieved in 145/152 (95.4%) and the median healing time was 24.6 days (range 16-31).
    • result Disease recurrence occurred in 7/152 (4.6%), who were re-operated using PEPSiT.
    • followUp The median follow-up was 12.8 months (range 1-36).

    Updates Surg · PMID 34021885 · Read it on PubMed ↗

  • Bonito et al. 2021

    A Retrospective Study of the Safety and Efficacy of a Radial Diode Laser Probe in the Management of Pilonidal Sinus Disease

    High success, low recurrence with laser.RetrospectiveLow quality

    25 people8.3 months

    84% success rate with 9.5% recurrence after a mean follow-up of 8.3 months

    Who was studied
    patients with pilonidal sinus disease
    What they received
    radial 1,470-nm diode laser treatment of the sinus
    Compared with
    none (no comparison group)
    Main outcome
    treatment success and recurrence of pilonidal sinus
    Quality
    This was a small retrospective study without a comparison group, so it cannot show whether the laser works better than other treatments.
    Limitations
    Retrospective design, no control group, small sample size, and short follow-up.

    Taken word for word from the abstract

    • n Twenty-five patients were included.
    • population Twenty-seven patients with pilonidal sinus
    • intervention treated with a radial 1,470-nm diode laser
    • comparator evaluate the safety and efficacy of a radial diode laser probe in the destruction of the pilonidal sinus
    • primaryOutcome The overall success rate was 84%. Recurrence rate was 9.5%
    • result The overall success rate was 84%. Recurrence rate was 9.5%, after a mean follow-up of 8.3 months.

    Dermatol Surg · PMID 33988547 · Read it on PubMed ↗

  • Algazar et al. 2022

    Sinus laser closure (SiLaC) versus Limberg flap in management of pilonidal disease: A short-term non-randomized comparative prospective study

    Comparable healing, quicker recovery with laserProspective cohortLow quality

    71 peopleshort-term

    SiLaC achieved 95.8% primary healing with similar recurrence to Limberg flap, but shorter operative time, hospital stay, and less pain

    Who was studied
    patients with pilonidal disease
    What they received
    sinus laser closure (SiLaC)
    Compared with
    Limberg flap surgery
    Main outcome
    healing rate and recurrence
    Quality
    Small, non-randomized study with short follow-up, so results may not hold up over time or in other patients.
    Limitations
    Non-randomized, short-term follow-up, small sample size

    Taken word for word from the abstract

    • n A short-term follow-up of 71 patients with pilonidal disease was analyzed
    • population 71 patients with pilonidal disease
    • intervention 24 operated on using the SiLaC technique
    • comparator 47 using the Limberg technique
    • primaryOutcome primary outcome is healing rate and recurrence
    • result Sinus laser Closure (SiLaC) is comparable to Limberg flap technique in the terms of healing rate and recurrence with better outcome regarding operative time, hospital stay and post-operative pain.

    Asian J Surg · PMID 33966964 · Read it on PubMed ↗

  • Kumar et al. 2021

    A mapping review of sacrococcygeal pilonidal sinus disease

    No outcome data on laserSystematic reviewVery low qualityRelated question

    size not given2021

    laser depilation was identified as a gap in research needing future randomised controlled trials, not as an evaluated treatment with outcomes

    Who was studied
    people with pilonidal sinus disease
    What they received
    laser depilation
    Compared with
    not specified
    Main outcome
    not reported for laser treatment specifically
    Quality
    this is a mapping review that counts and categorises existing studies rather than measuring whether laser treatment works, so it gives no outcome data to judge effectiveness.
    Limitations
    abstract states evidence base for pilonidal sinus management is 'poor quality, poorly focused and rapidly proliferating' and this review only maps study types rather than assessing treatment effects

    Taken word for word from the abstract

    • population Pilonidal sinus is a hole in the natal cleft which may cause severe pain and become infected.
    • intervention comparison of surgical techniques including flaps, laser depilation, and wound care interventions as potential areas for randomised controlled trials
    • result Gaps analysis highlighted comparison of surgical techniques including flaps, laser depilation, and wound care interventions as potential areas for randomised controlled trials.
    • primaryOutcome We extracted data on study design and categorised studies under five major headings
    • comparator comparison of surgical techniques including flaps, laser depilation, and wound care interventions as potential areas for randomised controlled trials

    Tech Coloproctol · PMID 33728570 · Read it on PubMed ↗

  • Esposito et al. 2020

    Standardization of Pre- and Postoperative Management Using Laser Epilation and Oxygen-Enriched Oil-Based Gel Dressing in Pediatric Patients Undergoing Pediatric Endoscopic Pilonidal Sinus Treatment (PEPSiT)

    Faster healing, fewer recurrences with laser.RetrospectiveLow quality

    87 people2020

    laser plus gel dressing group healed faster and had lower recurrence and infection rates than the spray-dressing group

    Who was studied
    pediatric patients aged 12-18 with chronic pilonidal sinus disease undergoing endoscopic surgical treatment
    What they received
    laser hair removal plus oxygen-enriched oil-based gel dressing before and after surgery
    Compared with
    silver sulfadiazine spray dressing after surgery only
    Main outcome
    wound healing time, disease recurrence, and wound infection rate
    Quality
    this was a retrospective comparison of two historical treatment protocols, not a randomized trial, so differences between groups could be due to other factors.
    Limitations
    retrospective design comparing two different time periods/protocols rather than a randomized comparison, small sample size, single center

    Taken word for word from the abstract

    • population 87 pediatric patients, 52 boys and 35 girls, with an average age of 17.1 years (range, 12-18) affected by chronic PSD, who underwent PEPSiT
    • intervention G1 (n = 47) treated with pre- and postoperative LE and oxygen-enriched oil-based gel dressing
    • comparator G2 (n = 40) treated with only postoperative dressing using silver sulfadiazine spray
    • primaryOutcome compared regarding the operative outcome, wound-healing time, disease recurrence, wound infections, and other complications
    • result The median healing time significantly decreased in G1 (21 days) compared with G2 (28.1 days) (P = 0.001]. The disease recurrence rate was significantly lower in G1 (n = 1, 2.1%) compared with G2 (n = 6, 15%) (P = 0.001), and the wound infection rate was significantly lower in G1 (n = 1, 2.1%) compared with G2 (n = 4, 10%) (P = 0.001)
    • n We retrospectively reviewed the data of 87 pediatric patients

    Lasers Surg Med · PMID 32964496 · Read it on PubMed ↗

  • Kurt et al. 2021

    Effect of platelet-rich plasma on healing in laser pilonidoplasty for pilonidal sinus disease

    Adding PRP sped up wound healing.Randomised trialLow qualityRelated question

    50 people2021

    wound healing was faster with PRP added (4.1 weeks) vs laser alone (6.1 weeks); other outcomes similar

    Who was studied
    patients treated for pilonidal sinus
    What they received
    laser pilonidoplasty plus platelet-rich plasma (PRP)
    Compared with
    laser pilonidoplasty alone
    Main outcome
    duration of wound healing, hospital stay, time to return to work, complications
    Quality
    Small study of 50 patients comparing two laser-based treatments, not laser versus no laser or standard surgery, so it doesn't directly test whether laser itself works.
    Limitations
    Small sample size; compares two variants of laser treatment rather than laser versus a non-laser standard treatment or no treatment; abstract does not mention blinding or randomization method.

    Taken word for word from the abstract

    • n Among the 50 patients included in the study
    • population Twenty-five patients who were treated by laser pilonidoplasty for pilonidal sinus (group 1) and 25 patients who were treated by platelet-rich plasma in addition to laser pilonidoplasty (group 2) at this clinic were included in the study.
    • intervention platelet-rich plasma in addition to laser pilonidoplasty
    • comparator laser pilonidoplasty for pilonidal sinus (group 1)
    • primaryOutcome Duration of stay of the patients in the hospital, time to start daily activities, duration of wound healing, recurrence, and complications were evaluated.
    • result duration of wound healing was 6.1 ± 2.3 and 4.1 ± 0.9 weeks in groups 1 and 2, respectively, and was shorter in group 2
    • result No statistically significant differences were found in the duration of hospital stay, duration of the procedure, time to return to work, and complication rates between the two groups.

    Lasers Med Sci · PMID 32862404 · Read it on PubMed ↗

  • Esposito et al. 2020

    Pediatric Endoscopic Pilonidal Sinus Treatment (PEPSiT) in Children With Pilonidal Sinus Disease: Tips and Tricks and New Structurated Protocol

    Oxygen-gel dressing healed faster than spray.RetrospectiveLow qualityRelated question

    127 people2020

    the oxygen-gel dressing group had a higher success rate, lower recurrence, faster healing and higher satisfaction than the silver-spray group

    Who was studied
    children and teenagers with pilonidal sinus disease having endoscopic surgery
    What they received
    endoscopic pilonidal surgery plus laser hair removal with an oxygen-enriched oil gel wound dressing (Group 1)
    Compared with
    endoscopic pilonidal surgery plus laser hair removal with a silver sulfadiazine spray wound dressing (Group 2)
    Main outcome
    surgical success, recurrence, wound healing time and patient satisfaction
    Quality
    it is a retrospective, non-randomized comparison of two wound-dressing protocols, and since laser hair removal was given to every patient in both groups, this study cannot show whether laser itself helped.
    Limitations
    retrospective, non-randomized design comparing two post-operative dressings; all patients in both groups received laser epilation so its specific contribution cannot be separated from surgery or dressing; patient satisfaction was a subjective score; single-center experience

    Taken word for word from the abstract

    • n We retrospectively reviewed the data of 127 pediatric patients
    • population 127 pediatric patients, who underwent PEPSiT for PSD in our institutions over a 36-month period
    • intervention G1 (laser + oxygen-enriched oil-based gel dressing) included 72 patients
    • comparator G2 (laser + silver sulfadiazine spray dressing) included 55 patients
    • primaryOutcome success rate, recurrence, wound infection rate, wound healing time, post-operative outcome, time to full daily activities and patient satisfaction
    • result The overall success rate was significantly higher in G1 (n = 71, 98.6%) compared with G2 (n = 50, 90.9%) [p = 0.001].

    Front Pediatr · PMID 32671004 · Read it on PubMed ↗

  • Liyanage et al. 2020

    Laser depilation as adjuvant therapy in prevention of recurrence of pilonidal sinus disease: initial experience of a district general hospital in the UK

    Fewer recurrences with more laser sessions.Prospective cohortLow quality

    57 people172 weeks

    12% recurrence rate, with more laser sessions linked to better outcomes

    Who was studied
    patients who had surgery for pilonidal sinus disease
    What they received
    laser hair removal after surgery to prevent recurrence
    Compared with
    no direct comparator group described
    Main outcome
    disease recurrence after one year
    Quality
    This was a single-group study without a comparison group, so it can't firmly prove laser treatment caused the improvement.
    Limitations
    No control group for comparison; abstract notes need for further high-quality controlled trials.

    Taken word for word from the abstract

    • n 57 were eligible for final analysis
    • population all consecutive patients who received laser depilation after elective surgery for pilonidal disease
    • intervention laser depilation after elective surgery for pilonidal disease
    • comparator Patients who had more than two sessions of laser depilation showed an improved recurrence rate.
    • primaryOutcome The primary outcome measure was disease recurrence.
    • result recurrence rate in our series was 12% at a median follow-up of 172 weeks

    Ann R Coll Surg Engl · PMID 32302208 · Read it on PubMed ↗

  • Yardimci 2020

    Outcomes of Two Treatments for Uncomplicated Pilonidal Sinus Disease: Karydakis Flap Procedure and Sinus Tract Ablation Procedure Using a 1,470 nm Diode Laser Combined With Pit Excision

    Faster recovery, less pain with laserRandomised trialLow quality

    58 people2020

    Laser treatment had shorter operative time, faster return to activity, less pain, and higher satisfaction, with similar recurrence rates

    Who was studied
    patients with uncomplicated early-stage pilonidal sinus disease
    What they received
    pit excision combined with sinus tract ablation using a 1,470 nm diode laser
    Compared with
    Karydakis flap surgery
    Main outcome
    operative time, pain, recovery time, satisfaction, and recurrence
    Quality
    Small randomized trial with short follow-up and no blinding described, so results may not hold up in larger studies
    Limitations
    Small sample size; abstract does not report follow-up duration or blinding methods

    Taken word for word from the abstract

    • n treated randomly, using KT (n = 28) or a PE/laser ablation technique (PE + LAT; n = 30)
    • population patients diagnosed with uncomplicated early-stage pilonidal sinus disease
    • intervention a combination of pit excision (PE) and sinus tract ablation using 1,470-nm diode laser
    • comparator the well-defined Karydakis technique (KT)
    • primaryOutcome The mean operative times were 36.4 (25-45) minutes in the KT group and 15.1 (12-20) minutes in the PE + LAT group.
    • result Compared with the KT, the PE + LAT was associated with a shorter operative time, a more rapid return to normal activities, less pain, and a higher level of subjective satisfaction.
    • result The groups did not differ in terms of recurrence.

    Lasers Surg Med · PMID 32064640 · Read it on PubMed ↗

  • Häfner 2019

    The body's integrated repair kit: Studying mesenchymal stem cells for better ligament repair

    Plasma gel, not laser, helped healingNarrative reviewVery low qualityRelated question

    size not given2019

    plasma gel treatment significantly improved wound healing

    Who was studied
    patients having pilonidal sinus surgery
    What they received
    platelet-enriched plasma gel (not laser)
    Main outcome
    wound healing after surgery
    Quality
    This is a brief editorial mention of another study with no details on methods, sample size, or design, so it cannot be judged reliable.
    Limitations
    The abstract is an editorial overview of several unrelated studies; it gives no information on study design, population size, or methodology, and the mentioned treatment is a plasma gel, not laser therapy, and the mentioned laser use is for an unrelated condition (twin-twin transfusion syndrome), not pilonidal cysts.

    Taken word for word from the abstract

    • population pilonidal sinus surgery
    • intervention platelet-enriched plasma gels
    • primaryOutcome wound healing after pilonidal sinus surgery
    • result platelet-enriched plasma gels significantly improve wound healing after pilonidal sinus surgery

    Biomed J · PMID 31948600 · Read it on PubMed ↗

  • Dessily et al. 2019

    The SiLaC procedure for pilonidal sinus disease: long-term outcomes of a single institution prospective study

    High healing rate, some recurrenceProspective cohortLow quality

    200 people2019

    94% healing rate with mean healing time of 19.5 days; 14.9% recurrence rate at long-term follow-up

    Who was studied
    patients with pilonidal sinus disease (first-time, not recurrent)
    What they received
    SiLaC procedure (sinus laser-assisted closure) for pilonidal sinus
    Compared with
    none - single-arm study, no control group
    Main outcome
    wound healing and recurrence rates
    Quality
    This was a single-arm study with no comparison group, so it cannot show whether laser treatment works better than other options, and only 77.5% of patients responded to the long-term recurrence survey.
    Limitations
    No control/comparator group; recurrence data relied on patient-reported mail/phone survey with 77.5% response rate; single institution.

    Taken word for word from the abstract

    • population consecutive patients with primary pilonidal sinus disease
    • intervention sinus laser-assisted closure (SiLaC) procedure
    • comparator A prospective study was conducted on consecutive patients with primary pilonidal sinus disease operated on with the SiLaC procedure
    • primaryOutcome try to determine what factors that could influence healing and recurrence
    • result The healing rate was high (94%) with a mean healing time of 19.5 ± 14.4 days.
    • result The recurrence rate was 14.9%.
    • n There were 200 patients.

    Tech Coloproctol · PMID 31773347 · Read it on PubMed ↗

  • Delshad et al. 2020

    Improving Resource Utilization and Outcomes Using a Minimally Invasive Pilonidal Protocol

    Better healing, lower cost than surgery.RetrospectiveLow quality

    51 people2020

    82% of minimally invasive protocol patients were healed or asymptomatic versus 18% of surgical excision patients, with lower charges

    Who was studied
    adolescents with moderate to severe pilonidal disease
    What they received
    minimally invasive pilonidal protocol (improved hygiene, laser epilation, and sinusectomy)
    Compared with
    surgical excision
    Main outcome
    healed or asymptomatic status at last follow-up, plus resource use (visits, OR time, charges)
    Quality
    This was a small retrospective comparison with a historical control group, not a randomized trial, so bias is likely.
    Limitations
    Retrospective comparative study comparing a historical surgical excision cohort to a later minimally invasive protocol cohort; small sample size.

    Taken word for word from the abstract

    • n 34 consecutive MIPP patients with moderate and severe disease were compared with a random sample of 17 SE patients
    • population adolescents with pilonidal disease
    • intervention Improved hygiene, laser epilation (LE), and sinusectomy were implemented as a minimally invasive pilonidal protocol (MIPP)
    • comparator versus surgical excision (SE)
    • primaryOutcome Number of visits, laser epilation (LE) treatments, care duration, operations, operating room (OR) time, charges, and condition at last visit were analyzed.
    • result At last follow-up, 82% of MIPP and 18% of SE patients were healed or asymptomatic (p < 0.01). Average charges were $29,098 for SE versus $8440 for MIPP (p < 0.01).

    J Pediatr Surg · PMID 31676078 · Read it on PubMed ↗

  • Noorah et al. 2019

    A hairy cavity: endoscopic therapy of a presacral recurrence of a complex pilonidal sinus

    No recurrence after two years.Case seriesVery low qualityRelated question

    1 peopleTwo years

    no recurrence two years after treatment

    Who was studied
    adult man with a complicated, recurrent pilonidal sinus that had spread deep into the pelvis after five prior surgeries
    What they received
    flexible endoscopic treatment combining cleaning, laser ablation (APC), and vacuum therapy
    Compared with
    his own history of prior open surgical resections
    Main outcome
    whether the sinus healed without recurring
    Quality
    this is a single patient case report, so it cannot show whether this works in general.
    Limitations
    only one patient, no comparison group, and the case was unusually complex and atypical.

    Taken word for word from the abstract

    • population A 43-year-old Caucasian man presented with an intrapelvic, pararectal recurrence of a primarily wide-stretched pilonidal sinus
    • n A 43-year-old Caucasian man
    • intervention Endoscopic therapy consisted of a combination of debridement, laser ablation and endoscopic vacuum therapy.
    • comparator a total of five attempts of surgical resection were performed, always confirming the diagnosis of a pilonidal sinus
    • primaryOutcome Two years after the end of the therapy, no recurrence was evident.
    • result Two years after the end of the therapy, no recurrence was evident.

    Int J Colorectal Dis · PMID 31435733 · Read it on PubMed ↗

  • Esposito et al. 2020

    Technical standardization of MIS management of children with pilonidal sinus disease using pediatric endoscopic pilonidal sinus treatment (PEPSiT) and laser epilation

    Nearly all wounds healed, low recurrence.Case seriesLow qualityRelated question

    59 people1 month

    all wounds healed by 1 month, with only 1 recurrence (1.6%) during follow-up

    Who was studied
    children with pilonidal sinus disease (acute or chronic)
    What they received
    endoscopic pilonidal sinus surgery (PEPSiT) combined with laser hair removal before and after surgery
    Compared with
    none (single group, no comparison treatment)
    Main outcome
    healing of the wound and recurrence of the cyst after treatment
    Quality
    this is a small single-group study without a comparison group, so it cannot show whether laser added any benefit over surgery alone.
    Limitations
    no control group, single center, level IV evidence, laser epilation only used in the last 15 months of the study period

    Taken word for word from the abstract

    • n A total of 59 patients (23 girls and 36 boys) underwent PEPSiT during the study period.
    • population All pediatric patients presenting with acute or chronic pilonidal sinus disease (PSD) who underwent PEPSiT in our institution
    • intervention All children underwent laser epilation pre- and postoperatively over the last 15 months.
    • intervention pediatric endoscopic pilonidal sinus treatment (PEPSiT) associated with laser epilation
    • comparator This study aimed to standardize the technique of pediatric endoscopic pilonidal sinus treatment (PEPSiT) associated with laser epilation.
    • primaryOutcome Pre- and postoperative management, recurrence rate, postoperative pain, hospital stay, analgesic requirements, and patient satisfaction levels were evaluated.
    • result At 1 month postoperatively, external openings were healed in all patients. During follow-up, 1 recurrence (1.6%) was recorded and successfully re-treated with PEPSiT.

    J Pediatr Surg · PMID 31126689 · Read it on PubMed ↗

  • Pronk et al. 2019

    [Chronic pilonidal sinus disease: overview of treatment options]

    May reduce pain and recurrence.Narrative reviewVery low quality

    size not given2019

    minimally invasive techniques including laser are associated with less pain and faster healing, and laser hair removal after surgery appears to lower recurrence risk

    Who was studied
    people with chronic pilonidal sinus disease, mostly young men
    What they received
    minimally invasive treatments such as laser (including laser hair removal)
    Compared with
    standard excision with primary or secondary wound healing, and other techniques like phenolisation or flap surgery
    Main outcome
    pain, wound healing speed, return to work, and recurrence of pilonidal sinus disease
    Quality
    this is a general overview article describing treatment options without presenting original study data, numbers of patients, or statistical results.
    Limitations
    no participant numbers, study design details, or statistical results are given; it is a narrative overview rather than a controlled study.

    Taken word for word from the abstract

    • population Pilonidal sinus disease is a common disease in predominantly young men
    • intervention Minimally invasive techniques, such as phenolisation, laser, and endoscopic treatments are increasingly applied
    • comparator excision with primary or secondary wound healing is often applied
    • primaryOutcome less pain, faster wound healing and facilitating a more rapid return to work for patients
    • result Laser hair removal at the natal cleft after surgical treatment appears to reduce the risk of recurrence.

    Ned Tijdschr Geneeskd · PMID 31120213 · Read it on PubMed ↗

  • Petersen 2019

    [Pilonidal Sinus Disease; What is the Best Treatment Option?]

    Laser results not yet established.Narrative reviewVery low quality

    size not given2019

    The abstract states that for laser and other newer destructive treatments, final evaluation of results is still pending, with no specific outcome data given

    Who was studied
    People with chronic pilonidal sinus disease (infection of hairy skin near the tailbone)
    What they received
    Minimally invasive, skin-preserving treatments including pit picking, fistuloscopy, phenol injection, and laser treatment
    Compared with
    Standard excision with open wound healing, and excision with plastic reconstruction
    Main outcome
    Treatment outcomes including recurrence rate, wound healing, and long-term results
    Quality
    This is a general narrative review that only mentions laser treatment in passing without presenting any specific study data or outcomes for it.
    Limitations
    The abstract does not report any study design, patient numbers, or outcome data specific to laser treatment; it is a general overview of pilonidal disease treatments.

    Taken word for word from the abstract

    • population Sinus pilonidalis is a chronic infection of the hairy skin in the area of skin wrinkles, with the most common localization in the natal cleft.
    • intervention so-called pit picking, fistuloscopy and other forms of treatment, such as phenol injection and/or laser treatment
    • comparator The standard treatment of excision and subsequent open wound treatment, has a low recurrence rate
    • primaryOutcome early post-operative results, wound healing disorder and long-term results
    • result In these treatment options, the final evaluation of the results is still pending.

    Zentralbl Chir · PMID 31117133 · Read it on PubMed ↗

  • Iesalnieks et al. 2019

    The Management of Pilonidal Sinus

    Unclear if laser lowers recurrence.Narrative reviewLow quality

    size not given2019

    not clear whether laser or endoscopic techniques lower the chance of the cyst coming back

    Who was studied
    people with pilonidal sinus disease (infection near the tailbone)
    What they received
    minimally invasive techniques, including laser treatment
    Compared with
    excisional surgical methods (such as off-midline closure techniques)
    Main outcome
    recurrence rate of pilonidal disease
    Quality
    This is a general narrative review of the literature rather than a controlled study specifically testing laser treatment, and it explicitly says the evidence is not yet clear.
    Limitations
    The review states further randomized trials are needed to clarify the role of newer techniques; no specific data on laser outcomes are given.

    Taken word for word from the abstract

    • population Pilonidal disease is an acute or chronic infection in the subcutaneous fatty tissue, mainly in the natal cleft.
    • intervention minimally invasive techniques employing laser or endoscopic technology
    • comparator excisional methods
    • primaryOutcome reduce the recurrence rate
    • result It is not yet clear whether minimally invasive techniques employing laser or endoscopic technology can reduce the recurrence rate.

    Dtsch Arztebl Int · PMID 30782310 · Read it on PubMed ↗

  • Delshad et al. 2019

    Pit-picking resolves pilonidal disease in adolescents

    Mainly tests pit-picking, not laser treatment.Case seriesVery low qualityRelated question

    58 people5.0 months (range 1-20)

    92% of patients with follow-up data were symptom-free at an average of 5 months

    Who was studied
    adolescents and young adults with pilonidal disease
    What they received
    pit-picking procedure (with laser hair removal added for hairy patients)
    Compared with
    none (single-group case series, no comparison group)
    Main outcome
    whether patients became symptom-free after the procedure
    Quality
    This is a small, uncontrolled case series where laser hair removal was just one added step for some patients, not the main treatment being tested, so it can't show whether laser itself works.
    Limitations
    No control group, 12% lost to follow-up, short follow-up, and laser was only used as an adjunct for hair removal in some patients rather than as the primary treatment studied.

    Taken word for word from the abstract

    • n Fifty-eight patients underwent at least one pit-picking from February 2016 to September 2017.
    • population The purpose of the study was to evaluate the outcome of pit-picking on adolescents with pilonidal disease.
    • intervention Hirsute patients also underwent laser hair epilation.
    • intervention they underwent pit-picking under local anesthesia
    • comparator TYPE OF STUDY: Case Series.
    • primaryOutcome Of the 51 patients with follow-up data, 47 (92%) were symptom-free an average of 5.0 months (range 1-20) post-procedure.
    • result 47 (92%) were symptom-free an average of 5.0 months (range 1-20) post-procedure

    J Pediatr Surg · PMID 30661599 · Read it on PubMed ↗

  • Kober et al. 2018

    Treatment options for pilonidal sinus

    Laser benefit unclear from this review.Narrative reviewLow qualityRelated question

    size not given2018

    off-midline repair is considered standard of care; no significant difference found between some surgical closure methods; laser therapy mentioned as a novel option without specific results given

    Who was studied
    people with chronic pilonidal sinus disease, often hirsute men
    What they received
    various treatments including conservative care, surgery, and laser therapy
    Compared with
    different treatment types compared to each other (e.g., primary vs secondary closure, Karydakis vs Limberg flap)
    Main outcome
    best approach to managing pilonidal sinus disease, including recurrence and recovery
    Quality
    this is a narrative review summarizing other studies without presenting new data or statistics on laser treatment specifically.
    Limitations
    abstract does not provide specific data, outcomes, or statistics for laser therapy; it is a general review of multiple treatment types.

    Taken word for word from the abstract

    • population Pilonidal sinus disease often presents as a chronic problem in otherwise healthy hirsute men.
    • intervention A range of conservative techniques to surgical flaps have been employed to treat this condition.
    • intervention as well as novel laser therapy
    • comparator no statistically significant difference has been noted between primary versus secondary closure or between the Karydakis flap and Limberg flap
    • primaryOutcome We review the literature on management of pilonidal sinus disease
    • result Given current evidence, off-midline repair is now considered the standard of care; however, no statistically significant difference has been noted between primary versus secondary closure or between the Karydakis flap and Limberg flap.

    Cutis · PMID 30489572 · Read it on PubMed ↗

  • Georgiou 2018

    Outpatient laser treatment of primary pilonidal disease : the PiLaT technique

    Most cysts healed with laser.Prospective cohortLow quality

    60 people12 months

    92% of patients healed completely, with low pain and high satisfaction

    Who was studied
    patients with primary (first-time, non-recurrent) pilonidal cyst disease
    What they received
    laser treatment of the cyst and sinus tracts (PiLaT technique) under local anaesthesia, outpatient
    Compared with
    none (single-arm, no comparison group)
    Main outcome
    complete healing (epithelization) of the cyst and tracts
    Quality
    This was a small, single-group study without a comparison treatment, so it can't show if laser works better than other options.
    Limitations
    No comparator group; single-arm observational design limits ability to attribute outcomes to the laser itself.

    Taken word for word from the abstract

    • population consecutive patients suffering from primary pilonidal disease
    • intervention minimally invasive technique pilonidal disease laser treatment (PiLaT) in treating primary (non-recurrent) pilonidal disease in an outpatient setting under local anaesthesia
    • comparator A prospective observational study was conducted on consecutive patients
    • primaryOutcome Successful treatment (complete epithelization of cyst and tracts)
    • result Successful treatment (complete epithelization of cyst and tracts) was documented in 55 out of the 60 patients (92% success rate)
    • n There were 60 patients, 51 males and 9 females
    • followUp Follow-up lasted 12 months.

    Tech Coloproctol · PMID 30306277 · Read it on PubMed ↗

  • Gys et al. 2018

    Fistula-tract Laser Closure (FiLaC™) for complex urethroperineal fistula

    Fistula tracts closed completely (different condition).Case seriesVery low qualityRelated question

    2 people3 months

    both patients had complete closure of the fistula tract after 3 months

    Who was studied
    patients with urethroperineal fistula caused by hidradenitis suppurativa
    What they received
    laser closure of the fistula tract (FiLaC)
    Compared with
    none (no comparison group)
    Main outcome
    closure of the fistula tract
    Quality
    Only two patients were treated with no comparison group, so the results are very uncertain and this abstract is not about pilonidal cysts.
    Limitations
    Abstract reports only 2 cases of a different condition (urethroperineal fistula from hidradenitis suppurativa), not pilonidal sinus/cyst disease, with no control group.

    Taken word for word from the abstract

    • n We present two patients who underwent surgery for urethroperineal fistula using this technique.
    • population We present two patients who underwent surgery for urethroperineal fistula using this technique.
    • intervention Fistula-tract Laser Closure (FiLaC™, Biolitec, Germany) is a novel technique already reported to have been used in the treatment of fistula-in-ano and pilonidal sinus.
    • comparator We present two patients who underwent surgery for urethroperineal fistula using this technique.
    • primaryOutcome In both cases, the fistula tracts were completely closed after 3 months of follow-up.
    • result In both cases, the fistula tracts were completely closed after 3 months of follow-up.

    Acta Chir Belg · PMID 30205751 · Read it on PubMed ↗

  • Hamnett et al. 2018

    Inferiorly based lotus petal flap & laser therapy in difficult pilonidal sinus management

    Laser's own effect unclear here.Case seriesVery low qualityRelated question

    14 people2018

    only 14% had prolonged wound healing and recurrence rates were lower than those in the literature

    Who was studied
    patients with difficult, often recurrent pilonidal sinuses treated between 2007 and 2015
    What they received
    lotus petal flap surgery with some patients also receiving Alexandrite laser hair removal
    Main outcome
    recurrence, re-operation, healing time, wound breakdown, discharge, infection, cosmesis and patient comfort
    Quality
    This is a small uncontrolled case series where laser was only one part of combined surgical treatment, so its own effect can't be separated out.
    Limitations
    Small sample of 14, no control group, laser used in only half the patients alongside surgery, so the laser's individual contribution to outcomes is not isolated.

    Taken word for word from the abstract

    • population We present a series of 14 patients who had a lotus petal flap reconstruction following pilonidal sinus excision between 2007 and 2015.
    • intervention 50% of patients underwent Alexandrite laser (755 nm wavelength) for a minimum of 6 treatments.
    • primaryOutcome Recurrence rates, re-operation rates, time for complete healing, wound breakdown, discharge, infection, cosmesis and patient comfort were assessed.
    • result Overall in this complex patient group only 14% had prolonged wound healing and recurrence rates were lower than those in the literature.
    • n We present a series of 14 patients

    J Plast Reconstr Aesthet Surg · PMID 30104141 · Read it on PubMed ↗

  • Halleran et al. 2018

    Laser Hair Depilation in the Treatment of Pilonidal Disease: A Systematic Review

    Fewer recurrences with laser hair removal.Systematic reviewLow quality

    size not given6 months to 5 years

    recurrence after laser treatment ranged from 0% to 28%, and 4 of 5 comparative studies showed lower recurrence with laser than without

    Who was studied
    people with pilonidal sinus disease (a cyst/infection near the tailbone)
    What they received
    laser hair removal (depilation)
    Compared with
    non-laser treatment (in some included studies)
    Main outcome
    rate of disease recurrence
    Quality
    mostly retrospective, small, and widely varying studies make it hard to trust the pooled result.
    Limitations
    Abstract states the literature is heterogeneous, mostly retrospective, with limited generalizability, and study sizes ranged from 1 to 86 patients.

    Taken word for word from the abstract

    • population patients with pilonidal sinus disease
    • intervention Laser hair depilation
    • comparator Four of the five studies that included a comparative group demonstrated a decreased recurrence rate compared to the non-laser cohort.
    • primaryOutcome rate of recurrence
    • result The pilonidal disease recurrence rate after laser depilation ranged from 0% to 28% at a mean follow-up ranging from 6 months to 5 years across studies.
    • result Four of the five studies that included a comparative group demonstrated a decreased recurrence rate compared to the non-laser cohort.
    • followUp mean follow-up ranging from 6 months to 5 years
    • limitations the literature published to date is heterogeneous and has limited generalizability

    Surg Infect (Larchmt) · PMID 30095368 · Read it on PubMed ↗

  • Pappas et al. 2018

    A new minimally invasive treatment of pilonidal sinus disease with the use of a diode laser: a prospective large series of patients

    High healing rate with laser.Prospective cohortLow quality

    237 people2018

    90.3% healed after first laser session, median healing time 47 days, low complication rate

    Who was studied
    patients with pilonidal sinus disease
    What they received
    minimally invasive diode laser treatment (SiLaT) of sinus tracts
    Compared with
    none (single-arm study, compared informally to published literature)
    Main outcome
    healing rate and healing time after laser treatment
    Quality
    This was a single-group study without a comparison group, so it can't prove the laser is better than other treatments.
    Limitations
    No control group; single-centre; relies on comparison to past published results rather than direct comparison.

    Taken word for word from the abstract

    • n Two-hundred and thirty-seven patients (183 male, median age 24 years, range 14-58)
    • population Patients suffering from pilonidal sinus
    • intervention SiLaT was applied under local anaesthesia after a small skin incision of 0.5-1 cm and careful cleaning of the sinus tracts with a curette.
    • comparator Clinical results showed low morbidity and recurrence rates comparable to the published literature for other modern techniques.
    • primaryOutcome evaluate the safety, efficacy and clinical outcome of a laser procedure for the treatment of pilonidal sinus
    • result A high healing rate was observed after the first session (90.3%, 214 of 237) with a median healing time of 47 days (range 30-70 days).

    Colorectal Dis · PMID 29878584 · Read it on PubMed ↗

  • Kelati et al. 2018

    Laser hair removal after surgery vs. surgery alone for the treatment of pilonidal cysts: a retrospective case-control study

    Fewer recurrences with laser hair removal.Case-controlLow quality

    41 people18 months (1-30 months) for LHR group and 30 months (6-72 months) for surgery alone group

    recurrence rate was much lower with laser hair removal (8.3%) than surgery alone (51.7%)

    Who was studied
    patients who had surgery for pilonidal cysts
    What they received
    laser hair removal after surgery
    Compared with
    surgery alone
    Main outcome
    rate of pilonidal cyst recurrence after surgery
    Quality
    Small retrospective case-control study with only 12 patients in the treatment group and uneven follow-up times between groups.
    Limitations
    Retrospective, small sample size, unequal follow-up durations between groups (18 vs 30 months median), single center.

    Taken word for word from the abstract

    • n Twelve patients - eight treated with alexandrite laser and four patients with Nd : YAG - were included in the cases group; 29 patients treated with surgery alone were included in the control group.
    • population We included all patients with PNC who had surgery during the period
    • intervention patients who had LHR after surgery
    • comparator those having surgery alone
    • primaryOutcome The main outcome was the prevalence and number of recurrences of PNC in each group.
    • result A significant decrease in the recurrence rate was observed after LHR (8.3%) compared to control group (P < 0.001).
    • followUp The median follow-up was 18 months (1-30 months) for LHR group and 30 months (6-72 months) for surgery alone group.

    J Eur Acad Dermatol Venereol · PMID 29633368 · Read it on PubMed ↗

  • Mutus et al. 2018

    Long-term analysis of surgical treatment outcomes in chronic pilonidal sinus disease

    No recurrences with laser hair removal.Case seriesVery low qualityRelated question

    268 people6-63 (median 25) months

    none of the patients who had laser hair removal had a recurrence, while recurrences occurred in some patients overall

    Who was studied
    adolescents who had surgery for chronic pilonidal sinus disease
    What they received
    laser hair removal (epilation) used after surgery in some patients
    Compared with
    patients who did not have laser hair removal after surgery
    Main outcome
    recurrence of pilonidal sinus disease
    Quality
    this was a retrospective case series with no comparison group and only a small subgroup had laser hair removal, so it can't reliably show whether laser helped.
    Limitations
    retrospective design, no comparison group, small subgroup receiving laser epilation, recurrence also linked to poor hygiene rather than laser use alone

    Taken word for word from the abstract

    • n There were 268 patients with a median age of 16years
    • population PSD patients surgically treated over an 8-year period were retrospectively evaluated
    • intervention Laser epilation was employed in 32 (28%) patients
    • comparator Recurrences were observed in 21 (7.8%) patients all having poor local hygiene.
    • primaryOutcome Recurrences were observed in 21 (7.8%) patients
    • result Laser epilation was employed in 32 (28%) patients, and none of these had recurrences.
    • followUp 6-63 (median 25) months after the surgery

    J Pediatr Surg · PMID 29217319 · Read it on PubMed ↗

  • Lopez et al. 2017

    Safety and Tolerability of Laser Hair Depilation in Pilonidal Disease: A Pilot Study

    Safe, well tolerated, no recurrences seen.Case seriesVery low quality

    13 peoplemedian follow-up of 13 months

    all treatments well tolerated with no burns, and all patients remained recurrence-free at follow-up

    Who was studied
    adolescents with pilonidal disease
    What they received
    laser hair removal of the natal cleft, every 4 weeks for up to 5 sessions
    Compared with
    none (single-arm study)
    Main outcome
    tolerability and safety of laser treatment (pain scores and burns)
    Quality
    Very small single-arm pilot study with no comparison group, so it cannot prove the laser itself prevents recurrence.
    Limitations
    Single-arm pilot study with only 13 patients, no control group, and short follow-up.

    Taken word for word from the abstract

    • population adolescents with pilonidal disease
    • intervention laser hair depilation to the natal cleft in 13 patients with pilonidal disease
    • comparator prospective, single arm, pilot trial
    • primaryOutcome The primary end point was tolerability and safety, defined as pain scores consistently <4 and no deep second-degree burns during the 24-hour post-treatment period.
    • result There was 100% tolerability of treatments with no occurrence of second-degree burns.
    • result All 13 patients were recurrence-free at a median follow-up of 13 months post-treatment initiation.
    • n Thirteen patients were enrolled with 12 patients completing five laser depilation treatment sessions and one patient completing only four.
    • followUp median follow-up of 13 months

    Surg Infect (Larchmt) · PMID 29016243 · Read it on PubMed ↗

  • Dragoni et al. 2018

    Treatment of recurrent pilonidal cysts with nd-YAG laser: report of our experience

    Cysts resolved, no recurrence seen.Case seriesVery low quality

    10 people2018

    all patients became symptom-free and cysts disappeared on ultrasound, with no recurrence during follow-up

    Who was studied
    patients with recurrent pilonidal cysts
    What they received
    Nd-YAG laser hair removal treatment
    Compared with
    no comparator (before-after ultrasound and symptom assessment)
    Main outcome
    symptom resolution and disappearance of cyst on ultrasound
    Quality
    This was a tiny uncontrolled study of only 10 patients with no comparison group, so it cannot reliably show the laser works better than other options.
    Limitations
    Very small sample size, no control group, abstract does not report length of follow-up period or blinding.

    Taken word for word from the abstract

    • population Ten patients affected by pilonidal cyst were examined and treated
    • intervention laser hair removal using the Nd-YAG laser for the treatment of pilonidal cyst
    • comparator soft-tissue ultrasounds performed before the first and after the last session
    • primaryOutcome Nine patients were asymptomatic after the second treatment
    • result In the follow-up, all the patients remained asymptomatic without any disease recurrence.
    • n Ten patients affected by pilonidal cyst were examined and treated

    J Dermatolog Treat · PMID 28521574 · Read it on PubMed ↗

  • Dessily et al. 2017

    Pilonidal sinus destruction with a radial laser probe: technique and first Belgian experience

    High success, few complications.RetrospectiveLow quality

    40 people234 days (92-316)

    87.5% success rate with a 2.9% recurrence rate

    Who was studied
    adults with pilonidal sinus disease
    What they received
    laser destruction of the pilonidal cyst using a radial laser probe (FILAC)
    Compared with
    none (single-arm case series)
    Main outcome
    treatment success (healing) rate
    Quality
    Small, retrospective, single-arm case series without a comparison group, so it cannot show if laser works better than other treatments.
    Limitations
    Retrospective design, no control group, small sample size of 40 patients.

    Taken word for word from the abstract

    • n we retrospectively studied the data of our 40 first patients
    • population patients operated with this technique
    • intervention destruction of the pilonidal cyst with a radial laser probe (FILACTM, Biolitec, Germany)
    • comparator Despite many non-surgical and surgical methods, no consensus emerged for the best treatment.
    • primaryOutcome The success rate was 87.5% (35 patients/40).
    • result The success rate was 87.5% (35 patients/40). Recurrence rate was 2.9% (1 patient/35).
    • followUp The mean follow-up period was 234 days (92-316).

    Acta Chir Belg · PMID 28056720 · Read it on PubMed ↗

  • Khan et al. 2016

    Control of hair growth using long-pulsed alexandrite laser is an efficient and cost effective therapy for patients suffering from recurrent pilonidal disease

    Found a benefitRetrospectiveLow quality

    19 people2016

    laser treatment led to longer disease-free periods and lower cost than repeat surgery

    Who was studied
    patients with recurrent pilonidal sinus after multiple surgeries
    What they received
    laser hair removal (long-pulsed alexandrite laser) in the sinus area
    Compared with
    previous surgical treatment
    Main outcome
    time without disease recurrence and cost per disease-free month
    Quality
    small retrospective study without randomization or control group comparison at the same time.
    Limitations
    retrospective design, small sample size, comparison to historical surgical outcomes rather than a concurrent control group

    Taken word for word from the abstract

    • n treating 19 patients suffering from recurrent pilonidal sinus with laser depilation
    • population patients who had recurrence of pilonidal sinus following multiple surgical treatments
    • intervention treated using long-pulsed alexandrite laser for depilation in the sinus area
    • comparator The disease-free period after laser treatment was significantly longer than that one after surgical treatment
    • primaryOutcome The disease-free period after laser treatment was significantly longer than that one after surgical treatment (p < 0.001).
    • result laser depilation is an efficient and cost-effective method of preventing recurrence and reducing morbidity and loss of man-hours

    Lasers Med Sci · PMID 27003897 · Read it on PubMed ↗

  • Braungart et al. 2016

    Improving outcomes in pilonidal sinus disease

    Fewer recurrences, but very preliminary.RetrospectiveVery low qualityRelated question

    18 people13months (3.5-67months)

    no further recurrence in patients who had laser hair removal, but authors call results preliminary

    Who was studied
    children and teenagers with previously infected pilonidal sinus disease
    What they received
    laser hair removal of the natal cleft after surgical excision
    Compared with
    patients who did not have laser hair removal
    Main outcome
    recurrence of pilonidal sinus requiring further surgery
    Quality
    Very small retrospective subgroup (7 of 18 patients) with no formal comparison group, so the laser result could easily be due to chance.
    Limitations
    Single-center retrospective review, small numbers, laser hair removal was an add-on to surgery in a minority of patients, not a controlled comparison.

    Taken word for word from the abstract

    • n Histology confirmed pilonidal sinus in 18/19 cases (one developmental malformation excluded from subsequent analysis).
    • population All had previously infected sinuses, with 5 requiring abscess drainage.
    • intervention Laser hair removal of the natal cleft was performed in 7/18 (39%) patients with no further recurrence.
    • comparator Laser hair removal of the natal cleft was performed in 7/18 (39%) patients with no further recurrence.
    • primaryOutcome Recurrence requiring further surgery occurred in 4/18 (22%) patients at a median of 9months (range 8-36)
    • result Our preliminary results of laser hair removal are promising but need to be evaluated with a prospective study.

    J Pediatr Surg · PMID 26690708 · Read it on PubMed ↗

  • Segre et al. 2015

    The treatment of pilonidal disease: guidelines of the Italian Society of Colorectal Surgery (SICCR)

    Reported to help, but evidence weakGuidelineLow qualityRelated question

    size not given2015

    satisfactory healing and recurrence rates reported, but evidence quality is low

    Who was studied
    people with pilonidal disease
    What they received
    laser epilation as part of nonoperative management
    Compared with
    other nonoperative treatments such as gluteal cleft shaving, fibrin glue and phenol injection
    Main outcome
    healing rates and recurrence incidence
    Quality
    The guideline itself states that most supporting studies are small with low-quality evidence.
    Limitations
    Abstract notes studies are small series with low-quality evidence and does not give specific data for laser alone.

    Taken word for word from the abstract

    • intervention laser epilation as well as fibrin glue and phenol injection
    • comparator gluteal cleft shaving, laser epilation as well as fibrin glue and phenol injection
    • primaryOutcome reported healing rates and recurrence incidence are satisfactory
    • result reported healing rates and recurrence incidence are satisfactory but the majority of studies are small series with low-quality evidence
    • population pilonidal disease, a very common condition, especially among young people

    Tech Coloproctol · PMID 26377583 · Read it on PubMed ↗

  • Bütter et al. 2015

    Hair epilation versus surgical excision as primary management of pilonidal disease in the pediatric population

    No outcome data given.RetrospectiveVery low quality

    size not given2015

    abstract only describes the study topic, no outcome data given

    Who was studied
    children with pilonidal disease
    What they received
    laser hair epilation
    Compared with
    surgical excision
    Main outcome
    recurrence rates and patient satisfaction
    Quality
    The abstract is retrospective and does not report any actual outcome numbers or statistics, only stating that recurrence and satisfaction will be discussed.
    Limitations
    No quantitative results, recurrence rates, or satisfaction scores are given in this abstract.

    Taken word for word from the abstract

    • population treated with LE versus surgical excision
    • intervention Laser hair epilation (LE) might solve this issue of poor patient compliance
    • comparator versus surgical excision in relation to findings from our institution
    • primaryOutcome we discuss recurrence rates of pilonidal disease in children treated with LE versus surgical excision
    • result we discuss recurrence rates of pilonidal disease in children treated with LE versus surgical excision in relation to findings from our institution between 2005 and 2013 as well as patient satisfaction with the treatment method.

    Can J Surg · PMID 26011854 · Read it on PubMed ↗

  • Koch et al. 2015

    The diverse application of laser hair removal therapy: a tertiary laser unit's experience with less common indications and a literature overview

    Reported to help pilonidal sinus disease.Case seriesVery low qualityRelated question

    31 people2015

    abstract states laser hair removal appeared effective for pilonidal sinus disease among other inflammatory conditions, especially early in disease, but no specific data for this subgroup are given

    Who was studied
    patients treated with laser hair removal for various uncommon conditions, including some with pilonidal sinus disease
    What they received
    laser hair removal therapy
    Compared with
    no comparator group
    Main outcome
    symptom and functional improvement with patient satisfaction
    Quality
    This is a small retrospective case series mixing many different skin conditions with no comparison group, so it can't reliably show whether laser helped pilonidal cysts specifically.
    Limitations
    Retrospective review of case notes; small total number of patients across many different indications; no control group; no separate outcome data for pilonidal sinus disease patients.

    Taken word for word from the abstract

    • n Thirty-one treated patients with the following indications were identified
    • population pilonidal sinus disease (PSD)
    • intervention laser hair removal (LHR) therapy
    • comparator Patients' case notes referred to the Birmingham Regional Skin Laser Centre between 2003 and 2011 for laser hair removal, with indications other than hirsutism, were reviewed retrospectively.
    • primaryOutcome leading to significant symptom and functional improvement with high patient satisfaction
    • result LHR appears effective in the treatment of chronic inflammatory conditions such as PSD, PFB and HS, particularly at an early disease stage.

    Lasers Med Sci · PMID 24173910 · Read it on PubMed ↗

  • Marza 2013

    Reducing the recurrence of pilonidal sinus disease

    Laser hair removal may cut recurrence.Narrative reviewVery low qualityRelated question

    size not given2013

    laser hair removal reduced the rate of recurrence

    Who was studied
    people with pilonidal sinus disease (a painful disorder between the buttocks)
    What they received
    laser hair removal
    Compared with
    no laser hair removal (standard care/surgery alone)
    Main outcome
    recurrence of pilonidal sinus disease
    Quality
    This is a narrative review/case report with no study data, numbers, or methods reported, so it cannot reliably support the claim.
    Limitations
    No participant numbers, study design details, or data are given; it is a general review combined with case reports rather than a controlled study.

    Taken word for word from the abstract

    • population Pilonidal sinus disease is a painful disorder of the natal cleft between the buttocks.
    • intervention Laser hair removal reduces the rate of recurrence by diminishing the number and thickness of hairs.
    • comparator Primary treatment is by surgery but there is a high recurrence rate.
    • primaryOutcome reduces the rate of recurrence
    • result Laser hair removal reduces the rate of recurrence by diminishing the number and thickness of hairs.

    Nurs Times · PMID 23905297 · Read it on PubMed ↗

  • Steinemann 2013

    [Therapy of pilonidal sinus--is more always better]

    No evidence given for laser.Narrative reviewVery low qualityRelated question

    size not given2013

    not quantified; laser epilation mentioned only as an option to consider on individual decision

    Who was studied
    people with pilonidal sinus disease (young men most commonly affected)
    What they received
    laser hair removal to prevent recurrence after surgery
    Main outcome
    preventing recurrence of pilonidal sinus
    Quality
    This is a general review article that only briefly mentions laser hair removal without any data or study results on its effectiveness.
    Limitations
    Abstract provides no data, numbers, or comparative results specifically for laser treatment; it is a general narrative review of surgical therapy with one sentence on laser as an adjunct.

    Taken word for word from the abstract

    • population Pilonidal disease is common in young men.
    • intervention To prevent recurrences a laser epilation has to be considered on individual decision.
    • primaryOutcome The recurrence rate after 4 years is 7 %.
    • result To prevent recurrences a laser epilation has to be considered on individual decision.

    Ther Umsch · PMID 23798021 · Read it on PubMed ↗

  • Girgin et al. 2012

    Minimally invasive treatment of pilonidal disease: crystallized phenol and laser depilation

    No recurrence after combined treatment.RetrospectiveVery low quality

    42 peoplemean 24 months (range, 6-30 months)

    all patients eventually healed with repeated treatments, and none had the disease come back during follow-up

    Who was studied
    patients with pilonidal cyst disease, chronic or recurrent
    What they received
    crystallized phenol treatment combined with 755-nm alexandrite laser hair removal
    Compared with
    none (single-arm study, compared to own historical hypothesis of improved outcome)
    Main outcome
    complete healing and recurrence of pilonidal disease
    Quality
    This was a small, retrospective study with no comparison group, so it can't prove laser added any real benefit.
    Limitations
    Retrospective design, no control group, some patients needed up to 8 treatments, small sample size

    Taken word for word from the abstract

    • n In total, 42 (31 male and 11 female) patients were treated with crystallized phenol and alexandrite laser depilation
    • population 38 patients (90.5%) had chronic disease and 4 (9.5%) had recurrent disease
    • intervention treated with crystallized phenol and 755-nm alexandrite laser depilation
    • comparator Patients who were treated with crystallized phenol and 755-nm alexandrite laser depilation were retrospectively analyzed.
    • primaryOutcome None of the patients had a recurrence during a mean 24 months
    • result None of the patients had a recurrence during a mean 24 months (range, 6-30 months) of follow-up.

    Int Surg · PMID 23294066 · Read it on PubMed ↗

  • Jain et al. 2012

    Use of lasers for the management of refractory cases of hidradenitis suppurativa and pilonidal sinus

    No recurrence after laser treatment.Case seriesVery low qualityRelated question

    9 people3 years

    no recurrence in any patient over follow-up

    Who was studied
    patients with hidradenitis suppurativa and pilonidal sinus, refractory to treatment
    What they received
    combined CO2 laser deroofing and long pulse Nd:YAG laser hair follicle removal
    Compared with
    none
    Main outcome
    recurrence of disease
    Quality
    Very small uncontrolled case series with only 5 pilonidal sinus patients, so little confidence can be placed in the result.
    Limitations
    small sample size, no control group, mixed conditions (HS and PNS) reported together

    Taken word for word from the abstract

    • n In 4 patients with HS and 5 patients with PNS
    • population Hidradinitis suppurativa (HS) and pilonidal sinus (PNS) are chronic inflamatory skin diseases, often refractory to treatment
    • intervention a technique combining the use of CO(2) laser and long pulse 1064 nm Neodymium-doped Yttrium Aluminium Garnet (Nd:YAG) laser
    • comparator we performed procedure in two steps: first destroying the hair follicles with long pulse Nd yag 1064 laserfollowed by deroofing with carbon di oxide laser
    • primaryOutcome None of the HS or PNS patients showed recurrence.
    • result None of the HS or PNS patients showed recurrence.

    J Cutan Aesthet Surg · PMID 23112515 · Read it on PubMed ↗

  • Ghnnam et al. 2011

    Laser hair removal as adjunct to surgery for pilonidal sinus: our initial experience

    Fewer recurrences with laser hair removal.Randomised trialLow quality

    size not given2011

    Laser group had no recurrences and reported the procedure comfortable with no complications, while the conventional-method group had two recurrences linked to difficulty maintaining hair removal

    Who was studied
    people who had surgery for pilonidal sinus disease
    What they received
    permanent laser hair removal after surgery
    Compared with
    conventional hair removal methods (razor, depilatory creams)
    Main outcome
    recurrence of pilonidal disease
    Quality
    The study is small, does not report overall patient numbers, and the authors themselves say larger studies with longer follow-up are needed.
    Limitations
    Total number of participants not reported; authors state larger studies with long-term follow-up are still needed to confirm the conclusion.

    Taken word for word from the abstract

    • result They found the procedure comfortable with no complications.
    • result Recurrence occurred in Group II patients (two cases) mostly due to failure in maintaining hair removal and area hygiene.
    • primaryOutcome as it decreases the chance of recurrence
    • intervention those using laser hair removal methods following completed healing of wounds (group I)
    • comparator regular post-healing conventional methods for hair removal, mainly razor and depilatory creams, for at least 6 months (group II)
    • population PATIENTS UNDERGOING SURGERY FOR PILONIDAL DISEASE WERE RANDOMIZED TO TWO GROUPS

    J Cutan Aesthet Surg · PMID 22279385 · Read it on PubMed ↗

  • Lindholt-Jensen et al. 2012

    Nd-YAG laser treatment of primary and recurrent pilonidal sinus

    Most symptom-free after laser treatment.Case seriesVery low quality

    41 people15.2 months

    75.7% symptom-free without extra treatment; 81% symptom-free with additional laser or minor surgery

    Who was studied
    patients with pilonidal sinus (primary and recurrent)
    What they received
    Nd-YAG laser treatment of the sinus tract
    Compared with
    none (no control group)
    Main outcome
    freedom from symptoms at follow-up
    Quality
    This is a small uncontrolled case series with no comparison group, so it can't show if laser works better than other options.
    Limitations
    No control group; preliminary experience; some patients needed additional surgery or laser treatment; described as 'preliminary'.

    Taken word for word from the abstract

    • n A total of 41 consecutive patients with pilonidal sinus underwent the intended Nd-YAG laser treatment.
    • population A total of 41 consecutive patients with pilonidal sinus underwent the intended Nd-YAG laser treatment.
    • intervention Nd-YAG laser waves in the treatment of pilonidal sinus
    • comparator We aim to substantially increase the cohort of patients undergoing this treatment and follow up these patients with a register-based technique with a comparable control group.
    • primaryOutcome At follow-up, 28 out of the 37 patients (75.7%) reported freedom from symptoms without supplementary treatment
    • result At follow-up, 28 out of the 37 patients (75.7%) reported freedom from symptoms without supplementary treatment, and 30 (81%) were symptom-free after supplementary laser treatment and minimal surgery, if needed.

    Lasers Med Sci · PMID 21927795 · Read it on PubMed ↗

  • Oram et al. 2010

    Evaluation of 60 patients with pilonidal sinus treated with laser epilation after surgery

    Fewer recurrences after laser hair removal.RetrospectiveLow quality

    60 people4.8 +/- 0.3 years

    13.3% recurrence rate after average 4.8 years follow-up

    Who was studied
    patients who had surgery for pilonidal sinus disease
    What they received
    laser hair removal (alexandrite laser) after surgery
    Compared with
    no comparator group; historical recurrence rates implied
    Main outcome
    recurrence of pilonidal sinus disease
    Quality
    This was a small retrospective chart review with no control group, so it can't prove laser treatment caused the lower recurrence.
    Limitations
    Retrospective design, no comparison group, relies partly on patient telephone interviews.

    Taken word for word from the abstract

    • n Sixty patients who underwent surgical treatment of pilonidal sinus disease
    • population Sixty patients who underwent surgical treatment of pilonidal sinus disease and were treated with a 755-nm alexandrite laser after surgery between 1999 and 2007
    • intervention treated with a 755-nm alexandrite laser after surgery
    • comparator The surgical treatments for pilonidal sinus disease often result in recurrences
    • primaryOutcome the patients were interviewed on the telephone about their post-laser period and recurrence
    • result The overall recurrence rate was 13.3%, after a mean follow-up period +/- standard error of the mean of 4.8 +/- 0.3 years.

    Dermatol Surg · PMID 20002644 · Read it on PubMed ↗

  • Badawy et al. 2009

    Effect of hair removal by Nd:YAG laser on the recurrence of pilonidal sinus

    Fewer recurrences after laser hair removal.Randomised trialLow quality

    25 people12 to 23 months

    none of the laser group needed more surgery, while 7 of 10 in the no-laser group had the condition come back

    Who was studied
    young men with pilonidal sinus (a chronic skin infection near the tailbone) after surgical removal
    What they received
    Nd:YAG laser hair removal in the area after surgery
    Compared with
    surgery alone, no laser hair removal
    Main outcome
    return of the pilonidal sinus needing more surgery
    Quality
    very small study with only 25 patients and it is not clear if treatment was randomly assigned.
    Limitations
    Very small sample size, unclear randomization method, short-to-moderate follow-up, single-center, all male patients.

    Taken word for word from the abstract

    • n Twenty five patients with PNS were included in this study.
    • population Fifteen patients underwent LHR treatment using Nd:YAG laser after surgical excision of PNS (Patients group) while ten subjects with PNS did not do LHR and served as a control group.
    • intervention laser hair removal (LHR) in the natal cleft area
    • comparator ten subjects with PNS did not do LHR and served as a control group
    • primaryOutcome the recurrence rate of PNS
    • result None of the patients, who underwent LHR, has required further surgical treatment to date. Seven patients out of ten in the control group have developed recurrent PNS.
    • followUp Follow up period lasted between 12 to 23 months.

    J Eur Acad Dermatol Venereol · PMID 19586514 · Read it on PubMed ↗

  • Petersen et al. 2009

    Long-term effects of postoperative razor epilation in pilonidal sinus disease

    Razor hair removal worsened recurrence; laser not testedRetrospectiveLow qualityRelated question

    504 people11.3 (standard deviation, 6.4) years

    patients who used razor epilation after surgery had higher recurrence than those who did not

    Who was studied
    patients who had surgery for pilonidal sinus disease
    What they received
    postoperative razor hair removal (epilation)
    Compared with
    no postoperative epilation
    Main outcome
    recurrence of pilonidal sinus disease
    Quality
    this was a retrospective telephone follow-up where patients self-selected whether to do epilation, so the groups may differ in other ways besides hair removal.
    Limitations
    Retrospective design, self-selected adherence to epilation recommendation, follow-up via telephone interview rather than clinical examination.

    Taken word for word from the abstract

    • population A total of 1,960 patients with pilonidal sinus treated surgically from 1980 to 1996
    • n A randomly selected sample of 504 patients was contacted for a follow-up telephone interview.
    • intervention Regular hair removal with a razor was recommended for all patients after surgery.
    • comparator 391 patients did not
    • primaryOutcome pilonidal sinus disease recurred in 111 (22 percent) of the 504 patients
    • result Recurrence was observed in 30.1 percent (34/113) of patients who performed postoperative epilation and in 19.7 percent (77/391) of patients who did not perform postoperative epilation (P = 0.01).
    • followUp The mean follow-up time was 11.3 (standard deviation, 6.4) years.

    Dis Colon Rectum · PMID 19273968 · Read it on PubMed ↗

  • Lindholt et al. 2009

    Nd-YAG laser treatment in a patient with complicated pilonidal cysts

    No recurrence after laser treatment.Case seriesVery low quality

    16 people3-month follow-up

    no recurrence at 3-month follow-up in all treated patients, including suppurative cases

    Who was studied
    patients with recurrent or suppurative pilonidal cysts
    What they received
    Nd-YAG laser treatment of the cyst
    Compared with
    no comparison group (case series); mentioned as alternative to open surgery
    Main outcome
    cyst recurrence after treatment
    Quality
    This is a small, uncontrolled case series with very short follow-up, so it cannot reliably show the laser works.
    Limitations
    No control group, very small number of patients, short follow-up period.

    Taken word for word from the abstract

    • n A similar success was observed for another 15 consecutively treated patients, including suppurative cases.
    • population A 38-year-old woman with a recurrent suppurative pilonidal cyst
    • intervention treated causally with an Nd-YAG (neodymium-doped yttrium aluminium garnet) laser
    • comparator The treatment could be a very attractive alternative to open surgery.
    • primaryOutcome with no recurrence at 3-month follow-up
    • result successfully treated causally with an Nd-YAG (neodymium-doped yttrium aluminium garnet) laser, and with no recurrence at 3-month follow-up

    BMJ Case Rep · PMID 21686748 · Read it on PubMed ↗

  • Lindholt et al. 2008

    [Treatment of pilonidal cyst with Nd-YAG laser]

    Cyst resolved in one patient.Case seriesVery low quality

    1 people9 months

    successfully treated with no recurrence after 9 months

    Who was studied
    a 23 year-old woman with a nonsupporative pilonidal cyst
    What they received
    Nd-YAG laser treatment
    Compared with
    none (no comparator, single case)
    Main outcome
    whether the cyst resolved without recurrence
    Quality
    This is a single patient case report, so it cannot show whether the treatment generally works.
    Limitations
    Only one patient was treated, with no comparison group, so results may not generalize.

    Taken word for word from the abstract

    • n A 23 year-old woman with a nonsupporative pilonidal cyst
    • population A 23 year-old woman with a nonsupporative pilonidal cyst
    • intervention was successfully treated causally with Nd-YAG laser
    • comparator The treatment could be a very attractive alternative to open surgery.
    • primaryOutcome without any recidivate after 9 months follow-up
    • result was successfully treated causally with Nd-YAG laser, and without any recidivate after 9 months follow-up

    Ugeskr Laeger · PMID 18570763 · Read it on PubMed ↗

  • Conroy et al. 2008

    Laser depilation and hygiene: preventing recurrent pilonidal sinus disease

    No recurrence after laser hair removal.Case seriesVery low quality

    14 people1-year follow up

    none of the patients had disease come back within a year

    Who was studied
    patients with recurrent pilonidal sinus disease after surgery
    What they received
    laser hair removal plus personal hygiene advice
    Compared with
    none (before-after comparison)
    Main outcome
    recurrence of pilonidal sinus disease
    Quality
    This was a very small study of only 14 patients with no comparison group, so it can't reliably show the laser caused the improvement.
    Limitations
    Small sample size, no control group, retrospective review of only 12 patients completing treatment.

    Taken word for word from the abstract

    • n A review of 14 patients who underwent laser hair depilation
    • population following pilonidal sinus surgery
    • intervention laser hair depilation in the natal cleft
    • comparator All patients were given advice regarding meticulous personal hygiene at the time of consultation.
    • primaryOutcome None of the patients developed recurrent disease at 1-year follow up
    • result None of the patients developed recurrent disease at 1-year follow up and, to date, none have required further surgery.

    J Plast Reconstr Aesthet Surg · PMID 17664085 · Read it on PubMed ↗

  • Sadick et al. 2006

    Laser and light treatments for pilonidal cysts

    Fewer recurrences after laser treatment.Case seriesVery low quality

    5 people7 months to more than 36 months

    4 of 5 patients stayed recurrence free for 7 months to over 36 months; one patient recurred after 36 months, a longer remission than before

    Who was studied
    patients with pilonidal cysts
    What they received
    diode laser or intense pulsed light (IPL) treatment
    Compared with
    traditional conservative treatment or surgery (historical, not directly compared)
    Main outcome
    recurrence of pilonidal cyst
    Quality
    This is a tiny report of only 5 patients with no comparison group, so it cannot reliably show the treatment works.
    Limitations
    Very small number of patients, no control group, and no statistical comparison to standard treatments.

    Taken word for word from the abstract

    • population Pilonidal (nest of hair) cysts are foreign body reactions accompanied by chronic inflammation.
    • intervention 5 patients treated with either a diode laser or intense pulsed light (IPL)
    • comparator Current accepted treatments include the traditional conservative treatments or aggressive surgery.
    • primaryOutcome produced results leaving the patients recurrence free
    • result Four of 5 patients remained recurrence free for 7 months to more than 36 months; one patient experienced a recurrence after 36 months, which was longer than his previous remission.
    • n 5 patients treated with either a diode laser or intense pulsed light (IPL)

    Cutis · PMID 16983902 · Read it on PubMed ↗

  • Schulze et al. 2006

    Treatment of pilonidal disease with laser epilation

    No recurrence after laser hair removal.Case seriesVery low quality

    23 people2006

    all 19 patients remaining in follow-up had no recurrence of folliculitis or need for further surgery

    Who was studied
    patients with recurrent pilonidal disease who had prior drainage or excision
    What they received
    laser hair removal added after surgical excision of the pilonidal sinus
    Compared with
    no comparison group; before/after same patients
    Main outcome
    recurrence of folliculitis or need for further surgery
    Quality
    This is a small, uncontrolled case series without a comparison group, so it cannot reliably show the laser itself caused the improvement.
    Limitations
    No control group; small sample; some patients lost to follow-up; wound dehiscence occurred in several patients.

    Taken word for word from the abstract

    • n Eighteen men and five women were treated with laser epilation in our office from 2001 to 2004.
    • population All patients had experienced recurrent folliculitis and had undergone some form of drainage procedure or prior excision.
    • intervention After surgical excision of the affected area, a Vasculite Plus laser was used for the epilation treatments.
    • comparator Eighteen men and five women were treated with laser epilation in our office from 2001 to 2004.
    • primaryOutcome All 19 of the patients that remain in follow-up report no recurrence of their folliculitis or need for further surgical procedures.
    • result All 19 of the patients that remain in follow-up report no recurrence of their folliculitis or need for further surgical procedures.

    Am Surg · PMID 16808209 · Read it on PubMed ↗

  • Landa et al. 2005

    Successful treatment of recurrent pilonidal sinus with laser epilation

    Fewer recurrences, no more surgery needed.Case seriesVery low quality

    6 people2005

    all patients improved with no further surgery needed and no complications

    Who was studied
    young men with recurrent pilonidal disease, some with prior surgery
    What they received
    laser hair removal in the natal cleft (alexandrite laser or intense pulsed light), 3 to 11 sessions
    Compared with
    no comparator group
    Main outcome
    resolution of folliculitis and need for further surgery
    Quality
    This was a very small study of only six patients with no comparison group, so it cannot reliably show the treatment works.
    Limitations
    Very small sample size, no control group, no blinding mentioned.

    Taken word for word from the abstract

    • n Six young men with recurrent pilonidal disease were treated with laser epilation
    • population Six young men with recurrent pilonidal disease were treated with laser epilation in our clinic from 2000 to 2003.
    • intervention An alexandrite laser was mostly used, although, occasionally, an intense pulsed light device was used. The number of epilation treatments ranged from 3 to 11, performed at 6- to 8-week intervals.
    • comparator Six young men with recurrent pilonidal disease were treated with laser epilation in our clinic from 2000 to 2003.
    • primaryOutcome To determine the effectiveness of laser hair removal in the natal cleft on pilonidal disease.
    • result All patients experienced progressive resolution of the folliculitis with the laser epilation treatments. No more surgical treatments have been needed.

    Dermatol Surg · PMID 15996432 · Read it on PubMed ↗

  • Lavelle et al. 2002

    Recurrent pilonidal sinus treated with epilation using a ruby laser

    Sinus healed, no recurrence.Case seriesVery low quality

    1 people6 months

    the sinus healed and had not recurred 6 months after the last treatment

    Who was studied
    a 33-year-old man with recurrent pilonidal sinus
    What they received
    ruby laser hair removal (epilation) applied to the scar area
    Compared with
    no comparator (single patient, before/after)
    Main outcome
    healing of the sinus without recurrence
    Quality
    this is a single patient case report with no comparison group, so it cannot show whether the laser caused the improvement.
    Limitations
    only one patient was studied, there was no control group, and follow-up was short.

    Taken word for word from the abstract

    • n a 33-year-old man who first presented at the age of 18 with a pilonidal sinus
    • population a 33-year-old man who first presented at the age of 18 with a pilonidal sinus
    • intervention The patient's scar was treated with a ruby laser using a pulse length of 2 ms and energy densities of 6.0-7.2 J/cm(2).
    • comparator Treatment was performed five times at 6-week intervals.
    • primaryOutcome The sinus healed and has not recurred to date, 6 months after the last treatment.
    • result The sinus healed and has not recurred to date, 6 months after the last treatment.

    J Cosmet Laser Ther · PMID 12470518 · Read it on PubMed ↗

  • Odili et al. 2002

    Laser depilation of the natal cleft--an aid to healing the pilonidal sinus

    All healed after laser hair removal.Case seriesVery low quality

    14 peopleOver a 5-year period

    all patients healed, with 4 needing further laser treatment; procedure was painful but had no complications

    Who was studied
    patients with recurrent pilonidal disease
    What they received
    laser hair removal (depilation) of natal cleft as an adjunct to treatment
    Compared with
    no comparator (case series, before/after)
    Main outcome
    healing of pilonidal sinus
    Quality
    This was a very small study of only 14 patients with no comparison group, so it can't prove the laser itself caused healing.
    Limitations
    Small sample size, no control group, retrospective follow-up via postal questionnaire.

    Taken word for word from the abstract

    • n 14 patients with recurrent pilonidal disease were treated in our unit with laser depilation
    • population 14 patients with recurrent pilonidal disease
    • intervention Laser removal of hair in the natal cleft is considered as an aid to healing the pilonidal sinus
    • comparator Over a 5-year period, 14 patients with recurrent pilonidal disease were treated in our unit with laser depilation
    • primaryOutcome allows the sinuses to heal rapidly
    • result All are now healed with no reported complications.

    Ann R Coll Surg Engl · PMID 11890622 · Read it on PubMed ↗

  • Walfisch et al. 1999

    Diamond-shaped optical fiber delivery system

    Device performed well, no cyst outcomes reportedLaboratory studyVery low qualityRelated question

    size not given1999

    The diamond-shaped tip was more durable, could be reused many times, and worked well during cutting and coagulating with no technical problems

    Who was studied
    Patients undergoing various surgical procedures (perianal fistulectomy, hemorrhoidectomy, condyloma removal, and pilonidal cyst/sinus excision)
    What they received
    A new diamond-shaped tip laser fiber delivery system (Nd:YAG and diode lasers) used for cutting and coagulating tissue
    Compared with
    Other commercially available optical fiber delivery systems
    Main outcome
    Durability and performance of the laser delivery device during surgery
    Quality
    This is a device engineering report describing a laser delivery tool tested across several surgery types, with no patient numbers, no comparison group outcomes, and no clinical results specific to pilonidal cysts.
    Limitations
    No participant numbers reported, no clinical outcome measures (like healing or recurrence) given, and pilonidal cyst surgery is only one of several procedures mentioned without separate results.

    Taken word for word from the abstract

    • intervention Distal tips of fibers used with Nd:YAG and diode lasers have been shaped and polished according to their specific function, including excision, vaporization, and coagulation of tissue.
    • intervention we have developed a prototype of a delivery system, called the Diamond-Shaped Optical Fiber Delivery System, or Diamond
    • population we applied it in surgical procedures such as perianal fistulectomy, hemorrhoidectomy, and excision of condilomata acuminata and pilonidal cyst and sinuses
    • comparator The delivery systems currently found on the market can burn and break easily.
    • primaryOutcome We searched for a delivery system with high power and with a tip of high durability that may be reused many times.
    • result During cutting and coagulating, the system performed well with no technical problems.
    • result Its main component, the diamond-shaped distal end, provided high durability and was reused many times, thus improving the quality of operations and reducing expenses greatly.

    J Clin Laser Med Surg · PMID 11199837 · Read it on PubMed ↗

  • Palesty et al. 2000

    Nd:YAG laser surgery for the excision of pilonidal cysts: a comparison with traditional techniques

    Faster return to work, less pain.RetrospectiveLow quality

    size not given2000

    laser patients returned to work sooner and had less pain than those with traditional surgery

    Who was studied
    people having surgery to remove pilonidal cysts
    What they received
    Nd:YAG laser cyst removal surgery
    Compared with
    standard (traditional) cyst removal surgery
    Main outcome
    pain, time off work, and patient satisfaction after surgery
    Quality
    This was a retrospective comparison without randomization and no reported number of patients, so bias and small sample size are likely.
    Limitations
    Retrospective design, no patient numbers given, pain and satisfaction assessed partly by phone questionnaire after the fact.

    Taken word for word from the abstract

    • population comparing Nd:YAG laser to the standard surgical technique
    • intervention Nd:YAG laser cystectomy
    • comparator the traditional pilonidal cystectomy
    • primaryOutcome addressing the length of time the cyst was debilitating both preoperatively and postoperatively as well as length of convalescent time before return to work
    • result Laser patients returned to work an average of 2.4 days earlier, and their postoperative pain was less than those treated traditionally.

    Lasers Surg Med · PMID 10805943 · Read it on PubMed ↗

  • Calbo et al. 1997

    [Day-surgery treatment of pilonidal sinus]

    Authors say laser helped, no data.Narrative reviewVery low quality

    size not given1997

    laser said to help prevent complications and speed healing, but no data given

    Who was studied
    people with pilonidal sinus disease (acute and chronic phases)
    What they received
    carbon-dioxide laser used with open surgical treatment
    Compared with
    open treatment without laser / closed treatment method
    Main outcome
    complications and healing time
    Quality
    this is a narrative discussion of the authors' experience with no numbers, control group, or data reported.
    Limitations
    No participant numbers, no study design details, no statistical results reported; appears to be an opinion/experience-based discussion rather than a controlled study.

    Taken word for word from the abstract

    • intervention Carbon-dioxide laser on Authors experience was very useful to prevent complications and to shorten healing time in open method.
    • result Carbon-dioxide laser on Authors experience was very useful to prevent complications and to shorten healing time in open method.
    • primaryOutcome to prevent complications and to shorten healing time
    • population Open and closed treatment are reported on the acute and chronic phases
    • comparator Open and closed treatment are reported on the acute and chronic phases, highlighting economical advantages of closed method.

    Chir Ital · PMID 12743878 · Read it on PubMed ↗

  • Chupryna et al. 1993

    [The radical treatment of a suppurating epithelial coccygeal cyst and of a cyst of the sacrococcygeal area]

    No clear result reported.Case seriesVery low quality

    65 people1993

    abstract does not report specific outcome data or statistics

    Who was studied
    patients with infected pilonidal sinus and cyst in the sacro-coccygeal region
    What they received
    radical excision of the cyst followed by helium-neon laser irradiation of the wound
    Compared with
    none stated
    Main outcome
    wound outcome after treatment
    Quality
    small uncontrolled case series with no comparison group and no detailed outcome data reported.
    Limitations
    no control group, no quantitative results given, very brief abstract

    Taken word for word from the abstract

    • n The results of treatment of 65 patients
    • population suppurated pilonidal sinus and cyst of the sacro-coccygeal region
    • intervention radical excision of the suppurated pilonidal sinus and cyst of the sacro-coccygeal region with subsequent irradiation of the wound with scattered beam of the helium-neon laser
    • comparator The results of treatment of 65 patients after radical excision of the suppurated pilonidal sinus and cyst of the sacro-coccygeal region with subsequent irradiation of the wound with scattered beam of the helium-neon laser are presented.
    • primaryOutcome are presented
    • result are presented

    Klin Khir (1962) · PMID 10912023 · Read it on PubMed ↗

  • Grubnik et al. 1993

    [The use of a laser in the surgical treatment of an epithelial coccygeal cyst]

    Fewer complications, no benefit in chronic cases.Case seriesVery low quality

    31 people1993

    Laser treatment reduced postoperative suppuration and pain in acute cases, showed no difference from conventional methods in uncomplicated chronic cases, and in complicated cases treated with the new technique no recurrence or scarring was noted

    Who was studied
    patients with pilonidal (epithelial coccygeal) cyst, including acute and chronic inflammation and complicated cases with fistulas
    What they received
    laser scalpel (CO2 laser) surgery for pilonidal sinus, including a technique for plastic wound closure using laser photohydraulic preparation
    Compared with
    conventional surgical treatment methods
    Main outcome
    postoperative complications (suppuration, pain, wound swelling), disease recurrence, and scarring
    Quality
    This is a small, non-randomized case series with vague reporting, so it cannot reliably show whether laser treatment truly works better.
    Limitations
    No control group for the complicated-case technique, no randomization, small sample size, and no clear duration of follow-up stated.

    Taken word for word from the abstract

    • population In acute inflammation of pilonidal sinus (PS)
    • population uncomplicated PS at the stage of chronic inflammation
    • population PS complicated by multiple fistulas, purulent leaks, pyodermia
    • intervention use of a laser scalpel
    • intervention For plastic closure of a wound, the effect of laser photohydraulic preparation was used
    • comparator conventional methods of treatment
    • primaryOutcome reduce considerably the incidence of postoperative suppuration
    • primaryOutcome Pain syndrome became less pronounced, or was absent, wound swelling disappeared at the early period
    • primaryOutcome no disease recurrence was noted
    • result permitted to reduce considerably the incidence of postoperative suppuration
    • result No differences in results of surgical treatment of uncomplicated PS at the stage of chronic inflammation in use of CO2-laser and conventional methods of treatment were noted
    • result Operated on was 31 patient, no disease recurrence was noted
    • n Operated on was 31 patient

    Klin Khir (1962) · PMID 10912022 · Read it on PubMed ↗

  • Klin et al. 1990

    The use of the CO2 laser in pilonidal sinus disease: preliminary results of an ambulatory prospective study

    Mostly healed within 4 weeksCase seriesVery low quality

    70 people1990

    most wounds healed within 4 weeks, complications were minor, and only 4.3% had major recurrence

    Who was studied
    young adults (mostly young men, median age 19) with pilonidal sinus disease treated as outpatients
    What they received
    surgery (incision/drainage or excision) plus CO2 laser therapy, curettage, and peroxide irrigation
    Compared with
    none - single group case series
    Main outcome
    healing time, complications, and recurrence of pilonidal sinus
    Quality
    this was a small uncontrolled case series with no comparison group, so it cannot show whether laser added any benefit over standard treatment.
    Limitations
    no control group, not randomized, described as 'preliminary results', and outcomes were not compared to a non-laser treatment arm.

    Taken word for word from the abstract

    • n 70 patients were treated for pilonidal sinus disease
    • population There were 62 men and 8 women, with a median age of 19 years (range 18 to 35).
    • intervention the surgical procedure included excision of sinus tissue and lateral fistulas, curettage, peroxide irrigation, and CO2 laser therapy with secondary healing
    • comparator All were managed as outpatients under local anesthesia.
    • primaryOutcome Healing time ranged from 14 days to 8 weeks, yet most sinuses healed in 4 weeks.
    • result All recurrences but three were minor and healed completely after additional local treatment (4.3 percent major recurrences).
    • qualityWhy Preliminary satisfactory results are reported, supporting a more conservative approach in the treatment of this often overtreated disease.

    J Clin Laser Med Surg · PMID 10160877 · Read it on PubMed ↗

  • Skobelkin et al. 1989

    [Carbon dioxide laser in the surgical treatment of proctologic diseases]

    Fewer complications, faster healing overallCase seriesVery low qualityRelated question

    556 people1989

    Fewer complications, half as many recurrences, and shorter hospital and recovery time with CO2 laser surgery

    Who was studied
    adults with various anorectal (proctologic) diseases
    What they received
    CO2 laser surgery for anorectal conditions
    Compared with
    not explicitly stated, implied comparison to standard surgical treatment
    Main outcome
    surgical outcomes including complications, recurrence rate, and recovery time
    Quality
    This is an old case series mixing many different anorectal diseases with no clear control group or statistical testing, so it can't reliably show the laser works for pilonidal cysts specifically.
    Limitations
    No randomization, no defined comparator group, mixed diagnoses lumped together, and pilonidal cysts not singled out as a specific outcome.

    Taken word for word from the abstract

    • n Results of the surgical treatment of 556 patients with different diseases of the anorectal area with the help of CO2 laser are presented.
    • population patients with different diseases of the anorectal area
    • intervention CO2 laser
    • comparator the amount of postoperative complications was 1.5 times less
    • primaryOutcome Functional results were good, the amount of postoperative complications was 1.5 times less, recurrences were half less, the time of intrahospital treatment was 1.5 day shorter, the period of ambulatory rehabilitation 3.8 days shorter.
    • result recurrences were half less, the time of intrahospital treatment was 1.5 day shorter, the period of ambulatory rehabilitation 3.8 days shorter

    Vestn Khir Im I I Grek · PMID 2515648 · Read it on PubMed ↗

How we searchedThe exact query, the date it ran, and what came back — so you can run it yourself.
Searched
PubMed · ClinicalTrials.gov · Crossref on 2026-10-13
The exact search — paste this into PubMed to repeat it
("Pilonidal Sinus"[Mesh] OR pilonidal cyst[tiab] OR pilonidal sinus[tiab]) AND (laser[tiab] OR "Laser Therapy"[Mesh] OR "Low-Level Light Therapy"[Mesh] OR laser ablation[tiab] OR laser hair removal[tiab] OR SiLaT[tiab])
PubMed expanded that to: ("Pilonidal Sinus"[MeSH Terms] OR "pilonidal cyst"[Title/Abstract] OR "Pilonidal Sinus"[Title/Abstract]) AND ("laser"[Title/Abstract] OR "Laser Therapy"[MeSH Terms] OR "Low-Level Light Therapy"[MeSH Terms] OR "laser ablation"[Title/Abstract] OR "laser hair removal"[Title/Abstract] OR "SiLaT"[Title/Abstract])
What came back
192 records found · 192 read · 149 answered the question
Included
  • Human, animal or laboratory studies reporting an outcome relevant to the question
Excluded
  • Records about a different condition or intervention
  • Records reporting no outcome
  • Retracted publications, which are listed but excluded from every count
Limits
  • Details were read from abstracts, not full papers, so anything reported only in a paper's methods section is not captured here.
  • Fields were read from abstracts, not full text, so detail reported only in a paper's methods section is not captured.
  • Evidence strength is adapted from the GRADE framework. It is not a GRADE assessment and was not produced by a GRADE panel.

Automated evidence review — PubMed, ClinicalTrials.gov, Crossref. Search strategy, grading rules and the checks that must pass before anything publishes were written by Allen Kamrava, MD, MBA, FACS, FASCRS, colon & rectal surgery, Beverly Hills. The pages themselves are compiled by software running that method and are not read one by one before publication — saying otherwise would be the one claim here that could not be checked.

How we grade evidence →

  1. 192records came back from the search
  2. 192were read
  3. 149actually answered the question
Why people try thisThe reasoning behind the question — not a claim that it works.
  • It sounds less invasive than cutting out the cyst, which appeals to people afraid of surgery or scarring.
  • It's often advertised as a quick, in-office procedure with little downtime.
  • After one or more surgeries that didn't fix the problem, people look for something different to try.
  • The idea of removing hair from the area to stop it causing problems again makes intuitive sense.
Common questionsShort answers, drawn from the same studies.
How is laser ablation used for pilonidal sinus?
In these studies, a thin laser fiber is passed into the sinus tract (the tunnel under the skin) and used to seal it shut from the inside. It's usually done under local anesthesia as an outpatient procedure, often in under 30 minutes.
Does laser hair removal help with pilonidal cysts?
The evidence is mixed. One trial of 302 people found that adding laser hair removal to standard care lowered the chance of the cyst coming back. But another trial of 60 people found the opposite — more cysts returned when laser hair removal was added to surgery. There isn't a clear answer yet.
Is laser treatment for pilonidal cysts available in Melbourne or near me?
This review summarizes what the research found about whether the treatment works, not where to get it. None of the studies looked at availability by location. Ask a local colorectal surgeon or dermatologist whether they offer sinus laser treatment or laser hair removal for this condition.
Should I stop laser hair removal if I'm using it for my pilonidal cyst?
Not necessarily, but don't assume it will prevent a recurrence. One well-run trial found it was linked to more cysts coming back when combined with surgery, while another found the opposite. Talk to your surgeon about what the evidence shows before relying on it alone.
What should I do instead of laser treatment?
Talk with a colorectal surgeon about conventional surgical options, such as flap surgery, which have been studied for longer with more consistent results. Laser treatment may still be reasonable in some cases, but current evidence doesn't show it's clearly better or safer than standard surgery.

This is information, not advice

This page summarises published research. It cannot tell you what is happening in your own body, and evidence changes. If something is bleeding, painful, or new, it is worth being looked at — that is a different question from the one on this page, and a better one to bring to a consultation.

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Automated evidence review — PubMed, ClinicalTrials.gov, Crossref. Search strategy, grading rules and the checks that must pass before anything publishes were written by Allen Kamrava, MD, MBA, FACS, FASCRS, colon & rectal surgery, Beverly Hills. The pages themselves are compiled by software running that method and are not read one by one before publication — saying otherwise would be the one claim here that could not be checked.

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