Treatment using pulsed dye lasers for port-wine stains without the use of general anesthesia was safe and effective in infants, according to a study published in JAMA Dermatology.
Researchers retrospectively analyzed data from medical records to evaluate the safety and efficacy of using pulsed dye laser treatment without general anesthesia on port-wine stain in children at the age of 1 or younger. Demographic information, lesion size and location, and procedure methodology were obtained from a high-volume laser center. Based on photographs, physicians rated the improvement due to treatments on a visual analog scale.
Of the 197 children included, 62.9% were girls, the mean age at the start of treatment was 3.38 months old, 75.6% had lesions on the face, and 90.9% had Fitzpatrick skin types I-III. The mean number of treatments was 9.8 with a mean treatment interval of 37.29 days. After treatment, 25.9% of the infants showed complete clearance, 41.1% showed excellent clearance, 22.3% showed good clearance, 6.6% showed fair clearance, and 4.1% showed poor clearance. Infants with a first branch of the trigeminal nerve lesion had a significantly higher clearance rate (P <.001), and infants with a third branch of the trigeminal nerve lesion had a significantly lower clearance rate (P =.04), but this significance was associated with the size of the lesions.
Limitations of this study include a lack of follow-up appointments, not including a control group, and that assessments were made from photographs.
Researchers concluded pulsed dye laser treatments without general anesthesia are safe and effective for infants with port-wine stain and their findings “support early in-office treatment, particularly when the treatment can be performed with minimal risk for complications.”
Jeon H, Bernstein LJ, Belkin DA, Ghalili S, Geronemus RG. Pulsed dye laser treatment of port-wine stains in infancy without the need for general anesthesia [published online March 13, 2019]. JAMA Dermatol. doi: 10.1001/jamadermatol.2018.5249