Can long-term alopecia occur after appropriate pulsed-dye laser therapy in hair-bearing sites? Pediatric dermatologists weigh in.
BACKGROUND
The risk of long-term alopecia after pulsed-dye laser (PDL) therapy is unknown. To identify how many practitioners treat hair-bearing sites with PDL and how commonly long-term alopecia occurs, the authors queried pediatric dermatologists about their experiences using this modality.


METHODS
A survey was designed to evaluate the frequency of and factors contributing to long-term alopecia after PDL treatment of port-wine stains (PWS). "Long-term" was defined as no sign of hair regrowth after several years of nontreatment. The survey was administered to attendees at the 2014 Society for Pediatric Dermatology biannual meeting.


RESULTS
Sixty-four pediatric dermatologists completed the survey, 50 of whom had experience using PDL. Of these physicians, 86% have used PDL to treat PWS of the eyebrow and 80% have treated PWS of the scalp. Over one-quarter of respondents (25.5%) using PDL on hair-bearing areas had at least 1 of their patients develop long-term alopecia after PDL treatment. The incidence of long-term alopecia after PDL treatment in the surveyed population was 1.5% to 2.6%.


CONCLUSIONS
The occurrence of long-term alopecia at hair-bearing sites after treatment with PDL may be greater than previously thought. Because the majority of physicians using PDL treat hair-bearing areas, prospective studies are needed to more accurately determine the risk of long-term alopecia and the factors that contribute to it.
*Division of Dermatology, Department of Medicine, University of California, San Diego, California; †Pediatric and Adolescent Dermatology, Rady Children's Hospital, University of California, La Jolla, California.
Stephanie
S
Feldstein
Christine R
CR
Totri
Sheila F
SF
Friedlander
D000505:Alopecia / Q000453:epidemiology*; D002648:Child; D003880:Dermatology / Q000706:statistics & numerical data*; D005138:Eyebrows; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D054025:Lasers, Dye / Q000009:adverse effects*; D028022:Low-Level Light Therapy / Q000009:adverse effects*; D019339:Port-Wine Stain / Q000628:therapy*; D012307:Risk Factors; D012535:Scalp