BOSTON – Using a 650-microsecond, pulsed 1064nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser to treat infantile hemangiomas can yield high clearance rates after one treatment, without adverse reactions, according to a study presented at the annual meeting of the American Society for Laser Medicine and Surgery.
“[Hemangiomas] have historically been treated with a bunch of different devices; most commonly, the pulsed dye laser and also propranolol, either orally or topically,” said Dr. David J. Goldberg of Skin Laser & Surgery Specialists of New York and New Jersey. While use of an Nd:YAG laser for treating infantile hemangiomas is not exactly new, “what’s new about this is it was not a millisecond Nd:YAG laser; it was a microsecond Nd:YAG laser, [which] generally makes it much safer for treatment in general.”
The study enrolled 250 children between age 1 month and 4 months at the time of recruitment; they were followed for one year. They received a single treatment with an Nd:YAG 1064nm laser using a 650 microsecond pulse duration, a spot size of 2-3 millimeters, and a fluence of 42-64 joules per square centimeter. Photographs were taken for evaluation immediately before and after each treatment, and 30 and 180 days after each treatment.
Treatments lasted 3-5 minutes each, covering an area no larger than three square centimeters. Infants who started treatment in the first six weeks of life had the best results, according to Dr. Goldberg. Treated areas immediately turned gray after each treatment on all subjects, and all subjects showed “substantial improvement” in hemangioma size after only a single treatment, based on photographic evaluation taken 6 months after treatment. Over 75% of hemangiomas were either completely or almost completely (over 75% clearance) eliminated over the 1-year follow-up period.
There was no downtime or adverse events experienced by any patients following treatments. Overall, parents of the children who received treatment were “highly satisfied” with the results.
“The big takeaway is that you may not need multiple treatments [and] you may not need to use a pulse dye laser – one treatment may be enough,” Dr. Goldberg explained. “This [Nd:YAG] device is also a very small device that you can put into a suitcase, so it’s not that big device that we’re used to using.”
Dr. Goldberg did not report any relevant financial disclosures.