Current Practices in Pediatric Dermatology Laser Therapy: An International Survey

Lasers Surg Med. 2021 Sep;53(7):946-952. doi: 10.1002/lsm.23327. Epub 2020 Sep 21.

Abstract

Background and objectives: To date, there are no well-established guidelines regarding laser therapy for the treatment of cutaneous lesions in pediatric patients. We aim to ascertain the types of lasers commonly used, types of lesions treated, and factors that affect the selection of specific laser modalities in pediatric patients.

Study design/materials and methods: An anonymous online survey was distributed to healthcare providers who treat children with lasers through listservs of four major national and international dermatology and laser organizations.

Results: Outpatient office-based procedure rooms are the most common clinical setting for laser procedures (74.4%), and pulsed dye laser is the most commonly used laser (95.4%). Conditions routinely treated with lasers included port wine stains (95.4%), infantile hemangiomas (81.5%), other vascular lesions (81.5%), scars (77.7%), and hair (60.8%). 84.4% of respondents expressed concern about general anesthesia in patients <2 years old. Nevi of Ota is treated with laser more frequently (52.3%) than other pigmented lesions.

Limitations: Limited generalizability of case examples to general conditions.

Conclusions: Vascular lesions are the most common lesions treated with lasers in pediatric dermatology patients, and most providers are using these devices in the outpatient setting. Many providers are concerned about the effects of repeated general anesthesia in infants, and there appears to be a trend toward providing laser therapy in the outpatient setting without general anesthesia. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

Keywords: café au lait; dermatologic surgery; hemangioma; hirsutism; lasers; nevus of ota; pediatric dermatology; pigmented; port wine stain; pulsed dye laser; vascular.

MeSH terms

  • Child
  • Child, Preschool
  • Dermatology*
  • Humans
  • Infant
  • Laser Therapy*
  • Lasers, Dye* / therapeutic use
  • Port-Wine Stain* / radiotherapy
  • Port-Wine Stain* / surgery
  • Skin Neoplasms* / surgery
  • Surveys and Questionnaires