Pilonidal disease predominantly occurs in young adults, especially men, usually manifesting between the ages of 15 and 30. This condition can be diverse in presentation and is not confined to any specific demographic group.
Presentation and Impact
Pilonidal cysts can exhibit itself in various forms—ranging from mere small holes in the intergluteal region, termed pit mouths, to infected or abscessed states. Individuals previously treated for pilonidal cysts can also experience recurrence.
Nature and Theories
Contrary to some beliefs, pilonidal disease is not congenital; rather, it’s an acquired ailment that emerges due to theories related to ingrown hairs. For instance, Surgeon Bascom proposes that it forms when hair roots in the midline are blocked with keratin, leading to widened pits in hair follicles. Conversely, Surgeon Karydakis argues it develops when shed hairs from the neck, back, and waist area pierce tiny holes in the skin in the intergluteal area.
Risk Factors
Several risk factors contribute to pilonidal cysts, such as obesity, prolonged sitting, male gender, excessive hairiness, and poor hygiene conditions.
Treatment Options and The Ideal Approach
Various surgical and non-surgical treatment options are available for pilonidal disease, yet there is no established gold standard treatment. The optimal treatment would ideally necessitate minimal hospitalization, ensure a rapid return to daily activities, be least painful, and offer the lowest recurrence probability.
Laser Treatment Evolution
Since 2014, laser treatment has been introduced as an innovative approach for pilonidal disease and is now a frequently used method. The Diode Laser, or SILAC method, has proven effective in treating this condition.
Silac Method Procedure
The SILAC method, applied under local or spinal anesthesia, requires no hospitalization, allowing patients to be discharged on the same day. During this procedure, a laser probe with a wavelength of 1470 nm and 10 W energy is used. Antibiotics are essential during and after the procedure to prevent infection.
The procedure involves widening and cleaning the holes in the ingrown hair of hair and bristles, combining these holes with a metal called a stylet, and advancing a brush through these holes to destroy the inner wall of the disease. Finally, the diseased area is obliterated with the laser probe, concluding the process.
Results and Preference
The SILAC procedure has emerged as an easily applicable treatment option yielding excellent results, positioning laser treatment as a preferred choice for addressing pilonidal disease.
Conclusion
Understanding the multi-faceted aspects of pilonidal disease and the advancements in laser treatment methodologies, such as the SILAC method, is crucial for those affected by the condition. Laser treatment for pilonidal disease has made significant strides, providing a less invasive, efficient, and promising solution for patients. The amalgamation of increased awareness, early diagnosis, and innovative treatments like laser therapy can substantially mitigate the impacts of pilonidal disease.
