Problems to be noted in the treatment of hemangioma

Parents of children with hemangioma always want the lesions to be removed immediately and have high hopes for laser treatment. Although many units are carrying out clinical work on laser treatment of hemangioma, the value of laser treatment for infant hemangioma is actually very limited. This is because laser is a physical therapy, and for hemangiomas in the prodromal phase, laser treatment alone cannot control the continued growth of the hemangioma. Secondly, the coagulation effect of the laser cannot stall the progression of the tumor because the penetration depth of the 577-585 nm pulsed dye laser to the skin is only 0.75-1.2 mm. The limited penetration depth of the laser is ineffective for deep (subcutaneous) hemangiomas. If the power is increased, regrettable scarring, pigmentation and other changes are often left behind. In addition, laser-treated skin is three times more likely to undergo atrophy and pigment loss than those that fade without treatment. Therefore, laser treatment of hemangiomas is limited to superficial skin hemangiomas that have stopped growing and are less than 2 mm thick. Parents should be encouraged to use laser treatment as the definitive treatment for residual capillary dilation, especially in nasal and lip lesions. The pulsed dye laser (PDL) is the standard laser for the treatment of vascular lesions and is primarily used for early intervention of superficial hemangiomas, management of ulcerated lesions, and treatment of residual capillary dilatation during the regression phase. The 595 nm long pulsed dye laser with skin cooling system has superior efficacy to conventional 585 nm PDL. low energy PDL irradiation of superficial hemangioma ulcers accelerates wound healing. pdl and long pdl are safe and effective for capillary dilation. Laser treatment should not be used as a routine treatment for hemangioma.