There is currently controversy surrounding the use of laser treatment for port-wine stains (PWS) in children, with specific concerns around the repetitive use of general anesthesia. Initiating treatment during infancy has been proposed as a way of avoiding the need for general anesthesia, as it is easier to hold the patient still during treatment. In this retrospective cohort study, investigators analyzed data from 197 children who started pulsed laser treatment without general anesthesia at age 1 year or younger in order to examine the safety and efficacy of pulsed laser treatment in this patient population. The primary outcome studied was improvement of PWSs, as defined by a 5-point visual analog scale (VAS). Investigators found that most patients (75.6%) had facial lesions. The mean age at the time of first laser treatment was 3.38 months, and the mean number of treatments was 9.8. Out of all patients, 25.9% showed complete clearance on VAS, 41.1% demonstrated a 76% to 99% improvement on VAS, 22.3% showed 51% to 75% improvement, 6.6% showed 26% to 50% improvement, and only 4.1% showed 0% to 25% improvement. No adverse events were reported. The results from this study suggest that treating PWS during infancy is efficacious. This study was limited in that it lacked a control group for comparison, and that assessments were performed on photographs that were not standardized.
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