Efficacy of early treatment of facial port wine stains in newborns: a review of 49 cases.
BACKGROUND
Port wine stains (PWS) affect 0.3-0.5% of both sexes of newborns, usually occurring on the face.


OBJECTIVE
To document safety and effectiveness of cryogen spray cooled, pulsed-dye laser at higher fluences than previously used to lighten facial PWS in infants < or =6 months, and establish that frequent treatment early in life yields better clearance than if delayed until later in life.


METHODS
Forty-nine infants who had been treated with pulsed-dye laser treatments for facial PWS at < or =6 months were identified by case review of photographs, age, sex, PWS severity score prior to laser treatment, number of treatments, and improvement following laser therapy.


RESULTS
Patients averaged 9.3 (range 2-16) treatments at 4-6 week intervals at 7.75-9.5 J/cm(2). Average surface area treated was 24.0% with 88.6% average clearance after 1 year. Average clearance was 90.7% for lesions covering <20% surface area and 85.6% for lesions > or =20%. Location (V1, V2, V3, eye, and/or scalp), treated surface area, treatment number, and fluence predicted clearance. Average clearance for sole involvement of V1 was highest (at 93.8%), followed by V2 (at 91.1%), V3 (at 84.3%), V1/V2 (at 83.7%), V1/V2/V3 (at 81.0%), periocular (at 88.6%), and scalp (at 89.9%). All patients tolerated the higher treatment fluences without atrophy or scarring.


CONCLUSIONS
Frequent, high energy pulsed-dye laser treatments are safe and highly effective in improving facial PWS in infants < or =6 months of age. Patients with PWS should be referred for pulsed-dye laser treatment during early infancy.
Chapas
Anne M
AM
Laser & Skin Surgery Center of New York, New York, NY, 10016, USA. achapas@laserskinsurgery.com
Eickhorst
Kimberly
K
Geronemus
Roy G
RG
D005148:Facial Dermatoses / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D053685:Laser Therapy / Q000379:methods*; D054025:Lasers, Dye / Q000627:therapeutic use*; D008297:Male; D019339:Port-Wine Stain / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome