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The Pilonidal Care Clinic: A Decade Overview of a Dedicated Pilonidal Care Clinic
Madelyn McArthur^*, Tayana Jean-Pierre, Ashley Stoeckel, Kathleen Renzi, Gheed Murtadi, Rachael Cohen, David P. Mooney
Department of Surgey, Boston Children's Hospital, Boston, MA

Purpose
Clinics dedicated to pilonidal disease (PD) are unusual in North America. This study aims to describe the experience of the inaugural 10 years of a dedicated Pilonidal Care Center (PCC) within a large academic pediatric center.
Methods
From PCC inception demographics including zip codes, intake disease severity, and interventions performed were prospectively collected in a REDCap database, which was reviewed to identify trends in PCC volume and modifications of clinic interventions from its establishment in March 2014 to December 2024. Descriptive statistics trends over time were calculated.
Results
Patient and Visit Volume
In 2013, before the clinic opened, 9 new patients were seen in the general surgery department outpatient clinic for PD. In 2014, the first year of the PCC, 47 new patients were managed. New patient volume grew variably by year with a sharp decline in 2020 secondary to a COVID-19 pandemic-induced clinic shutdown, before growing to 409 new patients in 2024 (Figure 1). Over its first decade, the PCC evaluated and managed 1,841 patients with PD. There were 85 clinic visits in 2014, growing to 2,008 clinic visits in 2024 (Figure 1). Since inception, there have been a total of 8,131 clinic visits.
Intervention Volume
In 2015, the PCC acquired a laser to ablate midline crease follicles and prevent the development of future pits. At first, the touching medial surfaces of the glutei were lasered, but laser follicle ablations were then limited to only the midline gluteal crease stripe, the location where pits originate. In total, approximately 6,265 laser follicle ablations have been performed.
In August 2016, the PCC began offering pit pickings, performing one procedure that year. Each year pit picking volume increased until a slight dip in 2022 before reaching 581 procedures performed in 2024 (Figure 1). In total, 1,816 pit pickings have been performed.
Laser follicle ablation and pit picking were offered at the patient’s first clinic visit starting in 2019. Since then, 78% of patients received laser follicle ablation and 45% a pit picking at their first clinic visit.
Geography
When analyzing the clinic growth by mapping the number of patients per zip code in Massachusetts, we see a steady inspection in the range of zip codes providing patients to the clinic (Figure 2). In addition, by 2024 patients from all 6 New England states and 21 other states, from as far as California and Washington State were seen.
Conclusion
In its first 10 years, the PCC has cared for 1,841 patients, performed 1,816 pit pickings, and approximately 6,265 laser follicle ablations during 8,131 clinic visits. The availability of in-office pit pickings and laser follicle ablation have expanded treatment options and contributed to the clinics’ success.