What is the role of laser surgery in the treatment of infantile hemangiomas?

Updated: Feb 06, 2019
  • Author: Richard J Antaya, MD; Chief Editor: William D James, MD  more...
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Answer

Laser surgery is beneficial in treating both proliferating and residual vessels from hemangiomas. The flashlamp-pumped pulsed-dye laser has become the most widely used laser for selective ablation of vascular tissue in childhood.

Pulsed-dye laser surgery is effective for treating ulcerated hemangiomas and thin superficial hemangiomas, especially those on areas likely to result in significant functional or psychological impact (eg, fingers, eyes, lips, nasal tip, ears, face). [12, 13] Many ulcerated hemangiomas respond with decreased pain (sometimes as early as a few days after the initial treatment), rapid reepithelialization, and hastened involution.

Treatments generally are performed every 2-4 weeks until complete healing results. Occasionally, particularly with deep or combined superficial and deep lesions, ulceration may worsen with pulsed-dye laser treatment. [70]

The risk of scarring or residual skin changes associated with pulsed-dye laser surgery of hemangiomas may be greater than without early laser treatment or with the treatment of capillary malformations (port wine stains), but the benefits of early involution should be weighed against the risks of a passive approach or alternative therapies. [52, 71]


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