Outcomes of Childhood Hemangiomas Treated with the Pulsed‐Dye Laser with Dynamic Cooling: A Retrospective Chart Analysis

BACKGROUND Laser treatment of childhood hemangiomas remains controversial. Previous studies have used outdated technology, resulting in a potential overrepresentation of adverse outcomes. OBJECTIVE To evaluate outcomes of hemangiomas treated with the most current laser technology. METHODS A retrospective chart analysis of 90 patients with a median age of 3.0 months and a total of 105 hemangiomas were enrolled over a 2.5‐year period. All were treated with the 595‐nm long‐pulse pulsed‐dye laser (LP‐PDL) with dynamic epidermal cooling at 2‐ to 8‐week intervals depending on the stage of growth. Exclusion criteria were previous laser, surgical, or corticosteroid treatment. Three reviewers assessed outcomes. RESULTS Near‐complete or complete clearance in color were achieved for 85 (81%) and in thickness for 67 (64%) hemangiomas. There was no scarring or atrophy. Ulceration occurred in one case and resolved during treatment. Hyperpigmentation and hypopigmentation occurred in 4% and 14% of hemangiomas, respectively. CONCLUSION Early treatment of childhood hemangiomas with the 595‐nm LP‐PDL with dynamic cooling may reduce the proliferative phase and result in excellent rates of clearing and few adverse events.