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Pilonidal Sinus and Hair Removal (article 4/7) Have you answered this month's poll? Keeping the pilonidal sinus area free from growing hair is a controversial issue at the best of times. Some surgeons strongly recommend hair removal, while others advise against it. This article explores the reasons for both sides of the argument and attempts to reach a conclusion as to whether pilonidal hair should be removed, which methods are best, and what circumstances influence these decisions. It is often the case that pilonidal sinus disease is caused by ingrown hair. When this hair first penetrates the skin, the skin is usually in a very strong, robust state. As such, considering how weak the skin is following surgery, there is a far higher chance of experiencing ingrown hair during healing than when the condition first started. If ingrown hair occurs during this recovery period, healing may be disrupted and further surgery will likely be required. Although removing hair from the area avoids this risk, it actually carries its own risks in itself. For example, depending on the method used, removed hair may not be cleared properly and so could find its way into the wound. Also, most forms of treatment tend to irritate the skin to a certain extent, which can potentially cause a lot of discomfort. Another risk, applicable only when using a razor, is cutting the surrounding skin and even the wound itself. This can happen due to the shape and contours of the natal cleft being difficult to manage. Looking at the arguments so far, it can be said that 'pilonidal sinus and hair removal' is a good thing providing that the process of hair removal is practised correctly. In other words, if all loose hair is cleared and the person carrying out the depilation is careful not to adversely affect the skin, hair removal can certainly be of an advantage. However, another factor now needs to be taken into consideration and that is: when hair removal should be performed. Naturally the surgeon will have any hair removed during the operation. This is an important point because it means that the possibility of ingrown hair is avoided during those initial weeks of healing, when the skin is at its most vulnerable. Since healing typically takes no longer than a matter of weeks, it is often the case that healing is complete by the time hair returns, if not soon afterwards. The question of relevance here is whether the wound, having healed, is still at risk of ingrown hair. The answer to this question is yes - to an extent. According to experts, following pilonidal surgery, it actually takes around one year for the skin to reach its original strength. As such, there is still a heightened risk of ingrown hair after initial healing has completed, albeit decreased. The exact extent of that risk also depends on other factors too, such as the coarseness of the person's hair, skin sensitivity and related medical history. Before making any conclusions, it is important to look at the available methods for pilonidal hair removal. As seen earlier in the article when associated risks were discussed, the methods of hair removal differ in terms of implications. There are many methods of hair removal to choose from but most will be inappropriate for a variety of reasons and only three of these should be considered. Shaving Shaving the hair with a razor is by far the simplest and quickest method available. However, one of the caveats of this method is that, due to the location of the pilonidal sinus, it can be hard to do this oneself. As such, it would be advisable if a partner, family member or even a district nurse were to perform this method, at least for the first time. For the razor, use of a single blade is recommended because the razor will need to be as small as possible in order to reach the more difficult areas with ease. Shaving foam should be avoided as this could cloud visibility which will be critical, and may irritate the wound. Afterwards, make sure to shower or bathe the area to debride the wound of loose hair. Some people like to use after-care products such as NoBumpRX. This is a lotion which helps to eliminate and prevent bumps, razor burns and ingrown hair. It can be purchased from Amazon.co.uk for around £10. However, as it is an American product, availability tends to be scarce in the UK. In fact, purchasing from Amazon.co.uk may result in the product being imported which will mean a slightly longer delivery time. Similar products should suffice. Electrolysis Electrolysis is a permanent hair removal method. It involves electricity being delivered to the hair follicles through probes. A lot of people, having had this method performed on their pilonidal wound, have found this experience to be quite painful. The advantage of this method is that hair removal tends to be truly permanent. Laser Treatment Laser treatment is another permanent hair removal method. Although the effectiveness of true permanent hair removal is known to be less effective than that of electrolysis, it remains to be the more common choice out of the two. Many people report very little pain with this method. This is helped by a numbing cream which can be applied prior to treatment. Treatment is provided by way of sessions spread over a number of months. The amount of sessions is often less than those required for electrolysis. Laser treatment is more expensive but the NHS can provide this treatment free of charge for those who have experienced or are experiencing significant problems with pilonidal disease. To summarise, when thinking about which methods should be chosen, it is clear that the permanent hair removal methods should be reserved for the more problematic cases. This, amongst other reasons, is because they take a lot of time to perform and can be expensive too. Out of the two permanent hair removal methods, laser treatment is the recommended choice. In most cases, assuming no problems have occurred, shaving is the advised method. Finally, in concluding whether to perform hair removal or not, this is perhaps best served by some examples. If a person heals from their operation without any complications and they do not wish for their wound to be kept hair-free, this would be an understandable decision and probably a harmless one too. However, as a small risk would be present, hair removal is recommended to ensure no problems occur. On the other hand, if the person experiences complications with healing and the wound fails to close, especially due to issues with hair, then hair removal is strongly recommended. Comments No comments yet. Add Comment