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Current Practices in Pediatric Dermatology Laser Therapy: An International Survey
Tiffany Y Loh1, Colleen H Cotton2, Jelena B Vasic1
1Division of Dermatology, University of Arizona, Tucson, Arizona.
Insights
Pediatric laser therapy commonly uses pulsed dye lasers for vascular lesions in outpatient settings. Providers prefer avoiding general anesthesia for infants, indicating a trend toward non-anesthetized treatments for children.
Area of Science:
- Pediatric Dermatology
- Laser Therapy
- Cutaneous Lesions
Background:
- No established guidelines for pediatric laser therapy.
- Need to understand current practices for treating pediatric skin conditions with lasers.
Purpose of the Study:
- Identify common lasers used in pediatric dermatology.
- Determine typical lesions treated with lasers in children.
- Explore factors influencing laser modality selection for pediatric patients.
Main Methods:
- Anonymous online survey distributed to healthcare providers.
- Survey targeted through dermatology and laser organization listservs.
- Data collected on laser types, treated lesions, and clinical settings.
Main Results:
- Pulsed dye laser is the most frequent laser used (95.4%).
- Vascular lesions (port wine stains, hemangiomas) are most commonly treated (95.4%, 81.5%).
- Outpatient settings are preferred (74.4%), with concerns about general anesthesia in young children (<2 years).
Conclusions:
- Vascular lesions are primary targets for pediatric laser treatment in outpatient settings.
- Concerns regarding general anesthesia in infants are driving a shift towards non-anesthetized laser procedures.
- Current practices highlight the need for evidence-based guidelines in pediatric laser therapy.
Background And Objectives:
To date, there are no well-established guidelines regarding laser therapy for the treatment of cutaneous lesions in pediatric patients. We aim to ascertain the types of lasers commonly used, types of lesions treated, and factors that affect the selection of specific laser modalities in pediatric patients.
Study Design/Materials And Methods:
An anonymous online survey was distributed to healthcare providers who treat children with lasers through listservs of four major national and international dermatology and laser organizations.
Results:
Outpatient office-based procedure rooms are the most common clinical setting for laser procedures (74.4%), and pulsed dye laser is the most commonly used laser (95.4%). Conditions routinely treated with lasers included port wine stains (95.4%), infantile hemangiomas (81.5%), other vascular lesions (81.5%), scars (77.7%), and hair (60.8%). 84.4% of respondents expressed concern about general anesthesia in patients <2 years old. Nevi of Ota is treated with laser more frequently (52.3%) than other pigmented lesions.
Limitations:
Limited generalizability of case examples to general conditions.
Conclusions:
Vascular lesions are the most common lesions treated with lasers in pediatric dermatology patients, and most providers are using these devices in the outpatient setting. Many providers are concerned about the effects of repeated general anesthesia in infants, and there appears to be a trend toward providing laser therapy in the outpatient setting without general anesthesia. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
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