Treatment of infantile hemangiomas with the 595‐nm pulsed dye laser using different pulse widths in an Asian population

Abstract

The pulsed dye laser (PDL) using varying fluences and pulse durations have been used to treat hemangiomas. This study aims to examine the efficacy and safety of the 595-nm PDL for the treatment of infantile hemangiomas using short (1.5-3 milliseconds) versus long (10 milliseconds) pulse durations and high fluences. This is a retrospective study of patients with hemangiomas (n = 23) treated with the 595-nm PDL from 2003 to 2007. The parameters used for the short pulse duration group (n = 15) were 7-mm spot size, fluence 10-13.5 J/cm(2) and dynamic cooling device (DCD) spray duration of 50 milliseconds and delay of 30 milliseconds. For the long pulse duration group (n = 8), parameters were 7-mm spot size, fluence 10.5-14.5 J/cm(2) and DCD spray duration of 40 milliseconds and delay of 20 milliseconds. The number of treatments required to achieve complete or near complete resolution of the hemangioma ranged from 3 to 14 for the short pulse duration group (mean: 8) and for the long pulse duration group, 4-14 treatments (mean: 9). For both groups, more treatments were needed to achieve clearance of mixed hemangiomas (n = 13) compared to superficial hemangiomas (n = 10) (on average, 4-5 treatments more). Erythema, edema, and purpura lasted for about a week in the short pulse duration group but only 2 days in the long pulse duration group. There was no ulceration or hypertrophic scarring noted in both groups. Both short and long pulse durations using moderately high fluences are equally effective in the treatment of infantile hemangiomas. Shorter pulse durations had a slightly higher incidence of side effects compared to longer pulse duration in our patients with darker phototypes. Hemangiomas are tumors with relatively large diameter blood vessels and this provides the basis for the use of longer pulse durations.