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Weekly Pulsed Dye Laser Treatments for Port-Wine Birthmarks in Infants
Shirin Bajaj1,2, Joy Tao1, David A Hashemi1
1Laser & Skin Surgery Center of New York, New York.
Insights
Weekly pulsed dye laser (PDL) treatments for port-wine birthmark (PWB) in infants led to significant clearance in most patients. This early, frequent treatment approach showed promising results with no adverse events.
Area of Science:
- Dermatology
- Pediatric Laser Therapy
- Vascular Malformations
Background:
- Early treatment of port-wine birthmark (PWB) is crucial for improved outcomes and quality of life.
- Shorter treatment intervals show potential for more rapid PWB clearance, but optimal intervals remain undefined.
Purpose of the Study:
- To evaluate the effectiveness of once-weekly pulsed dye laser (PDL) treatments for infantile port-wine birthmarks.
- To describe the clearance rates and safety profile of this intensive treatment regimen.
Main Methods:
- A case series involving infants under 6 months with PWB receiving once-weekly PDL treatments.
- Photographic assessments were conducted 2 months post-treatment initiation to grade PWB improvement.
- Outcomes were categorized based on percentage of PWB clearance.
Main Results:
- 70% of patients achieved near-total (76%-95%) or total (96%-100%) PWB clearance within 2 months.
- The remaining 30% experienced marked improvement (51%-75%) and achieved near-total clearance with further treatment.
- No adverse events were reported during the treatment period.
Conclusions:
- Once-weekly PDL treatments in early infancy can lead to substantial PWB clearance with a favorable safety profile.
- This accelerated treatment interval may shorten overall treatment duration and improve patient outcomes.
- Further research into this 1-week treatment interval for PWB is warranted.
Importance:
Early treatment of port-wine birthmark (PWB) can be life-altering and is often associated with improved outcomes and quality of life. There is growing evidence that shorter treatment intervals may play a role in more rapid PWB clearance; however, the optimal treatment interval has not been established.
Objective:
To describe the outcomes of once-weekly pulsed dye laser (PDL) treatments for PWB in infants.
Design, Setting, And Participants:
This case series analyzed the medical records of patients with PWB who received once-weekly PDL treatments between January 1, 2022, and December 31, 2023, at the Laser & Skin Surgery Center of New York. These patients were younger than 6 months. Before-and-after treatment photographs were independently assessed and graded 2 months after initiation of treatment.
Intervention:
Once-weekly PDL treatments.
Main Outcomes And Measures:
The primary outcome was the percentage improvement of PWB, which was graded using the following scale: 0% (no improvement), 1% to 25% (mild improvement), 26% to 50% (moderate improvement), 51% to 75% (marked improvement), 76% to 95% (near-total clearance), and 96% to 100% (total clearance).
Results:
Of the 10 patients (6 males [60%]; median [range] age at first treatment, 4 [<1 to 20] weeks) included, 7 (70%) had experienced either near-total clearance (76%-95%) or total clearance (96%-100%) of their PWB with once-weekly PDL treatments after 2 months. The other 3 patients all saw marked improvement (51%-75%) and subsequently went on to achieve near-total clearance with additional treatments. The median (range) duration of treatment and number of treatments to achieve near-total or total clearance in all patients were 2 (0.2-5.1) months and 8 (2-20) treatments, respectively. No adverse events were noted.
Conclusion And Relevance:
This case series found that once-weekly PDL treatments for PWB in the first few months of life was associated with near-total or total clearance of PWB with no reported adverse events, suggesting improved outcomes can be achieved with shorter overall treatment duration. Further investigation into this novel decreased treatment interval of 1 week is warranted.
