The use of 595-nm pulsed-dye laser (PDL) combined with 0.5% timolol maleate solution is safe and effective as local treatment for patients with superficial infantile hemangiomas (IH), according to study findings published in Clinical, Cosmetic and Investigational Dermatology.
Researchers assessed the safety and efficacy of 595-nm PDL combined with topical timolol solution for superficial IH and compared its efficacy for early and late hemangiomas in patients at a dermatology clinic from July 2019 to July 2020. Laser treatment was conducted in 4-week intervals, according to individual patient variables.
The patients were categorized into early (≤2 months, n = 45) and late (>2 months, n = 122) groups. The early group had 24 females and ranged in age from 20 to 60 days (mean, 48.2 ± 2.64). The late group had 62 females and had an age range of 2 to 12 months (mean, 6.25 ± 1.18).
Digital photographs were taken before each treatment and 6 months after the first treatment and were reviewed by 2 independent, double-blinded physicians to determine the degree of clinical improvement and therapeutic effect.
The early group included 45 cases of superficial IH—1 patient had grade I regression, 1 patient had grade II regression, 12 patient had grade III regression, and 31 patients had grade IV regression. Treatment in the early group had an efficacy rate of 95.5%. The late group included 122 children—7 patients had grade I regression,10 patients had grade II regression, 42 patients had grade III regression, and 63 patients had IV regression. Treatment in the late group had an efficacy rate of 86.1%. Treatment efficacy rate in the early group was significantly higher vs the late group (P = .031).
The early group had 3.51 ± 0 50 months of treatment, and the late group had 4.73 ± 0.68 months of treatment. The treatment groups had “faster results and a shorter treatment time” compared with the control group, which was statistically significant (P < .001).
Among early group participants, 37.78% of patients developed blisters and scabs, which were treated with topical fusidic acid cream for 1 week. In the late group, 20.49% of patients had blisters and scabs that were effectively treated, and post-treatment pigmentation occurred in 11.47% of patients.
The investigators noted that although the treatment endpoint was 6 months, some patients required more treatments to achieve better results. Also, the follow-up was only 6 months, and the study could have missed long-term sequelae and disease recurrence.
“Early treatment of IH was associated with fewer treatments, better curative effects, and a lower risk for sequelae,” the study authors commented. “595-nm PDL combined with timolol maleate solution shows strong promise for the treatment of superficial IH in children in the clinical setting.”
Shi W, He H, Jiang J, Gao Y, Quan H. Timing and efficacy of 595-nm pulsed-dye laser combined with 0.5% timolol maleate solution in the treatment of superficial infantile hemangiomas. Clin Cosmet Investig Dermatol. 2021;14:1593-1599. doi:10.2147/CCID.S337850