Contact:Missy Gough, (847) 240-1734 [email protected]
Karen Klickmann, (847) 240-1735[email protected]
Jennifer Gale, (847) 240-1730[email protected]EMBARGOED UNTIL OCTOBER 18, 2000
NEW LASER SURGERY TREATMENTS IMPROVE THE APPEARANCE AND SELF-ESTEEM OF CHILDREN WITH BIRTHMARKS
NEW YORK (October 18, 2000) -- The birth of a baby is an exciting and joyful time for a family filled with hopes and dreams for the future. Parents anticipate that their child will grow up to be a confident and successful adult. Yet, the presence of a birthmark may not only compromise a child's outward appearance, but also his or her self-esteem for years to come.
"Birthmarks can affect both the physical and emotional development of a child," stated dermatologist Robin Ashinoff, M.D., Assistant Professor, Department of Dermatology, New York University Medical Center, New York, New York, speaking today at the American Academy of Dermatology's Derm Update 2000. "Yet, new laser treatments are available today that can significantly improve a child's quality of life."
"The teasing and staring that children with birthmarks often endure makes them self-conscious and may cause them to withdraw from social contact," continued Dr. Ashinoff. "After I have treated a child with a birthmark, the parents always tell me what a positive influence I have had on their child's life. Lasers have truly revolutionized the treatment of these disfiguring skin conditions."
Port-Wine Stains
Port-wine stains are red, pink, or purple discolorations which are found most often on an infant's face, neck, arms, or legs. Present at birth, the exact cause of these lesions is unknown. Port-wine stains occur in almost 1 percent of newborns, affecting an equal number of boys and girls. The size of the lesion increases as the child grows. In time, the affected skin may thicken and nodules may form on the surface and bleed. Untreated, port-wine stains will last a lifetime.
"The pulsed dye laser was developed specifically to treat port-wine stains in children," stated Dr. Ashinoff. "One of the advantages of treating a child's port-wine stain as early as possible is that an infant's lesion and its blood vessels are smaller. In addition, early treatment dramatically improves a child's self-esteem."
Babies as young as several weeks of age can be effectively treated with the pulsed dye laser. Prior to the treatment, a topical anesthetic may be applied to the lesion, the child is immobilized, and his or her eyes are covered to shield them from the laser light. Depending on the size of the lesion, a treatment to an infant's face may last only five-to-ten minutes. The child usually will only experience mild discomfort similar to repeated pinching or multiple snaps of a rubber band.
Immediately after laser treatment, the lesion turns purple-gray, which may darken over the next 24 hours and last for 10-to-14 days. Multiple treatments, spaced approximately two months apart, are usually necessary to attain the degree of lightening desired. The risks of scarring or permanent changes in the skin's pigmentation are very small with the pulsed dye laser.
Despite multiple treatments, and even the use of stronger and deeper lasers, not all port-wine stains can be removed. In general, lesions on the head and neck are the most responsive to treatment, although the middle cheek and upper lip may be a little difficult. Since the legs can be resistant to laser therapy, they may require many additional treatments.
Hemangiomas
Hemangiomas are lesions which develop on infants within a couple of weeks after birth. A hemangioma, which initially may look like a whitish area surrounded by dilated blood vessels, can grow very rapidly during the first six-to-nine months of a child's life. These lesions are very common in children, with an incidence of almost 10 percent by age one. Hemangiomas are more frequent in girls than boys and are also associated with premature birth, multiple births, and the use of fertility drugs by the child's mother.
"While 50 percent of hemangiomas will regress by age five and 70 percent by age seven, early treatment is recommended," remarked Dr. Ashinoff. "Untreated hemangiomas will often leave the child with a lingering lesion as well as scarring."
The pulsed dye laser is also successfully used to treat hemangiomas. Treating the hemangioma while it is still relatively flat and small increases the regression process and reduces the growth of the lesion with very few side effects. If the lesion is too large, the laser will not be very effective due to a limited depth of penetration.
Occasionally, a hemangioma will ulcerate creating painful sores that are difficult to heal. Although the pulsed dye laser can aid this healing process, frequent multiple treatments, such as once every three weeks, are necessary since these lesions are still growing.
Pigmented Birthmarks
The advent of lasers has also greatly improved the treatment of pigmented birthmarks in children. The Q-switched lasers, such as the Q-switched ruby and the Q-switched Nd:YAG, have been used in children to treat cafe-au-lait spots, epidermal nevi, nevus spilus, and Nevus of Ota. Following treatment, the Q-switched lasers cause immediate whitening of the pigmented birthmark. The lesion may then darken over the course of one week, and then gradually lighten over the next several weeks. As with the pulsed dye laser, multiple treatments are necessary to achieve the best results.
Epidermal nevi, tan patches which appear in infancy, are very responsive to the Q-switched ruby laser, which does not change the skin's texture or pigment. Nevus spilus, a lesion with a tan background encompassed by darker areas, also responds well to Q-switched laser treatment.
Nevus of Ota, a light brown to dark blue lesion which often covers a person's cheek, forehead, or eye, is most commonly seen in the Asian population. The most complete removal of this lesion can be achieved with three or four treatments with the Q-switched ruby laser, spaced at several month intervals.
Cafe-au-lait spots do not respond as well to laser treatment as other pigmented birthmarks. While some of these light brown patches may respond to treatment, the cafe-au-lait spots may later return.
"Laser technology has advanced quickly in the last 15 years and will continue to grow," explained Dr. Ashinoff. "In the future, newer, more selective and effective laser systems will become available for treatment of birthmarks in children."
The American Academy of Dermatology, founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of over 13,000 dermatologists worldwide, the Academy is committed to: advancing the science and art of medicine and surgery related to the skin; advocating high standards in clinical practice, education, and research in dermatology; supporting and enhancing patient care; and promoting a lifetime of healthier skin, hair and nails. For more information, contact the AAD at 1-888-462-DERM or www.aad.org.
The American Society for Dermatologic Surgery (ASDS) was founded in 1970 to promote excellence in the field of dermatologic surgery and to foster the highest standards of patient care. For more information on cosmetic skin surgery and referrals to doctors in specific geographic areas, please contact the ASDS Consumer Hotline, 1-800-441-ASDS (2737), during weekday business hours or visit our Web site at www.asds-net.org.
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