Diode Laser for the Treatment of Telangiectasias following Hemangioma Involution

Abstract

Objectives: Infantile hemangiomas are the most common benign tumor of infancy and are well known for their rapid growth during the first 6 to 9 months of life, followed by a spontaneous but slow involution. The standard of care is to treat these lesions at an early age with propranolol to expedite the involution process. Residual telangiectasias often result following involution. We evaluated the efficacy of using a diode laser as an adjunct treatment for cervicofacial infantile hemangiomas. Methods: Twenty patients, aged 4 months to 11 years, underwent treatment with a 532-nm diode laser as part of the management for their hemangiomas. The fluence was 10.2 to 25 J/cm2, pulse durations of 36 to 44 ms, spot sizes of 0.7 to 2 mm, and pulse frequency of 3 to 5 Hz. All procedures were performed in the operating room. In order to assess the efficacy, pre- and posttreatment digital photography were evaluated independently by the authors and ranked on a 0 to 4 point scale (0 = no change and 4 = complete response). Adverse reactions were also recorded. Results: The telangiectasias showed significant improvement following treatment. In more than half of the patients treated, the affected area demonstrated a complete response. No adverse reactions were noted. Conclusions: A 532-nm diode laser effectively treats the remaining telangiectasias following hemangioma involution. The treatment is well tolerated and demonstrates excellent results. Whether used independently or in conjunction with other treatment modalities, the diode laser should be part of the surgical armamentarium when treating infantile hemangiomas.