What are the nonsurgical treatments for pilonidal disease?

Updated: Jun 11, 2018
  • Author: M Chance Spalding, DO, PhD; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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There are several medical treatments for pilonidal sinuses. It is fairly widely agreed that an abscess formed from a pilonidal sinus should undergo surgical treatment with incision and drainage. However, regimens for elective treatment of pilonidal sinuses vary widely.

One of the simplest medical treatments of pilonidal sinuses is to shave the sacral area free of hair and to pluck all visible embedded hair in the sinus. There have been several suggestions of applying laser hair removal treatments to this region to decrease the likelihood of further exacerbations. To date, however, no clinical trials have documented success with this therapy as compared with more traditional treatments. [13]

Lord and Millar popularized their technique of coring out the midline epithelial follicles, but they also included a brush in their procedure to cleanse the cored cavity of hair and any hair left over in the remaining laterally oriented, granulation-lined tract. The brushing of the tracts continues in the outpatient setting until the tract heals completely and closes. The follicle excision sites may be closed primarily but are usually packed and dressed to heal by secondary intention.

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