When lasers aren't appropriate
Indications for children include, but are not limited to, hemangiomas, port-wine stains, pigmented lesions, hamartomas and scars. These are largely conditions children have had since birth.
In some cases — such as with some port wine stains — there are benefits to early treatment, but in other cases, physicians may want to reconsider the timeframe for treatment. When a child has a skin condition with minimal cosmetic impact and if there’s no significant benefit from early treatment, a physician may opt to delay laser treatment because the condition might improve on its own in time.
For example, if a six-year-old child has a prominent spider angioma on his face, discuss the likelihood of it getting better, or getting worse. Or, if a parent or child’s expectation for a procedure isn’t realistic, then forgo treatment, Dr. Ross says.
“Lasers are one of the most challenging and rewarding aspects of my practice. Although it sometimes requires extra work to get children through procedures, it is worth it — given the significant impact the surgeries can make for the rest of their lives. Observable and functional deformities have lifetime influences. I have seen tremendous psychological effects from untreated birthmarks as well as tremendous satisfaction from intervention with laser technology,” Dr. Eichenfield says.
1. Shahriari M, Makkar H, Finch J. “Laser therapy in dermatology: Kids are not just little people,” Clinical Dermatology. Oct. 23, 2015. DOI: 10.1016/j.clindermatol.2015.09.010.
2. Andrew C. Krakowski, MD, Christine R. Totri, MD, et al. “Scar Management in the Pediatric and Adolescent Populations,” Pediatrics. Feb. 2, 2016.