Combination therapy of infantile hemangiomas with pulsed dye laser and Nd:YAG laser is effective and safe

Background: Infantile hemangiomas (IH) can cause severe complications like obstruction, ulceration or heart failure. Therefore, in certain difficult-to-treat areas or in absent regression an early and sufficient therapy is required. As systemic treatments like the beta-blocker propranolol or oral corticosteroids can lead to serious side effects in rare cases, effective and well-tolerated local treatment options as an additive or alternative would be desirable. Patients and Methods: In this retrospective interdisciplinary study 38 children with 77 IH were treated with the pulsed dye laser (PDL) (595 nm) and Nd:YAG laser (1 064 nm). The treatment success and the side effects were evaluated on the basis of objective parameters like sonographically proven depth extend as well as subjectively by the parents of the children. Results: All 77 treated IH responded to the therapy, of which 52.8 % had healed after the end of treatment and 47.2 % showed only a minimum residual. The success of treatment was assessed by the parents in 92.6 % as very good or good. As the main side effect in 45.9 % a transient blistering occurred. Conclusions: The combination therapy with PDL and Nd:YAG laser represents an effective local therapy against IH with minimal side effects.