Treatment & Care
Hearing that your child has a capillary malformation can be frightening. But you can rest assured that at Children’s Hospital Boston, your child is in good hands.
At Children’s, we consider you and your child integral parts of the care team and not simply recipients of care. You and your care team will work together to customize a plan of care for your child.
We can’t emphasize enough that most of the time a capillary malformation shouldn’t cause any serious health problems for your child. Still, having a birthmark can be psychologically or socially difficult, and you may decide that you’d like to treat your child’s capillary malformation with laser therapy.
What are our options for cosmetic treatments?
At Children’s, we use a device called a pulsed dye laser to destroy the abnormal blood vessels in the capillary malformation. Pulsed dye laser is the gold standard of treatment for capillary malformations because it is highly effective and rarely causes any scarring.
How does it work?
First, the doctor “tunes” the laser to a specific wavelength of light. It produces a bright light that is absorbed by blood vessels. The abnormal blood vessels are then destroyed without damaging the surrounding skin.
What’s the treatment like?
Your child’s physician holds a wand against the skin and "pulses" the laser for about a minute. During the treatment, your child wears eye protection because laser light can potentially harm the eyes.
Is the treatment painful?
Not really. The laser light feels a bit like a rubber band snapping against the skin. Afterwards, your child may feel a bit of pain equivalent to a minor sunburn.
- If you’re worried about your child’s reaction to the discomfort, we can give her a topical anesthetic.
- Tylenol can also help reduce the pain.
Are there any side effects?
There are a few minor side effects:
- Immediately after the treatment, your child’s skin will be purple where the laser was focused. This lasts for seven to ten days.
- As the purple fades, the treated area may still look red, but will slowly fade to normal skin color over the next few weeks.
- In a few kids, crusting may develop in the first several days and last up to two weeks.
- Some kids may experience a temporary brown discoloration of the skin for several months.
What else do we need to know about the treatment?
- Avoid direct exposure to the sun for three weeks prior to the treatment. Sunburned and suntanned skin absorbs the laser light and make the treatment less effective.
- You should also avoid situations where your child’s skin will be exposed to the sun for long periods of time (like at the beach) for several months after the treatment. We recommend always applying a sunscreen with SPF 15 or greater.
- Avoid aspirin and aspirin-like products for 14 days prior to treatment.
- You may want to apply antibiotic ointment and a bandage to your child’s skin immediately after treatment.
What kind of results can we expect?
Every kid is different and every capillary malformation responds differently to laser therapy. Laser therapy usually succeeds in lightening the stain, but doesn't make it go away completely.
Are there any complications with pulsed dye laser therapy?
Not really. But there are a few other things to keep in mind when considering laser therapy:
- It can often take several treatments to lighten the birthmark.
- Sometimes, the stain can come back after treatment.
- In a very small number of kids, laser therapy doesn’t work at all.
At what age should we begin treatment?
We recommend starting treatment when your child is an infant. At this time, the stain is still small and so it’s much easier to treat.
However, if your child is older, we can still treat her with the pulsed dye laser, though it may require more treatments to lighten her birthmark.
In the rare case that your child has an underlying condition, we’ll refer him to the appropriate specialists to design a treatment plan.
Coping & support
We understand that you may have a lot of questions when your child is diagnosed with a capillary malformation. We’ve tried to provide some answers to those questions in these pages, and we have a number of other resources to help you and your family.
Patient education: From the first office visit, our nurses will be on hand to walk you through your child’s treatment and help answer any questions you may have, such as: Does my child need treatment? What can we expect next? They will also reach out to you by phone, continuing the care and support you received while at Children’s.
Parent to parent: Want to talk with someone whose child has undergone laser therapy? We can often put you in touch with other families who can share their experience at Children’s.
Counseling: As your child gets older, he may be uncomfortable with his birthmark, especially if it’s in a prominent location such as on the face or neck. One of our counselors can help your child deal with the psychological and social issues related to having a birthmark.
On our For Patients and Families site, you can read all you need to know about:
- getting to Children’s
- navigating the hospital experience
- resources that are available for your family
And here are a few helpful pages with more information about capillary malformations:
- Our Vascular Anomalies Center has a page with links to organizations that offer support and education for parents who have a child with a vascular anomaly.
- The National Organization of Vascular Anomalies has an informative site.
- You can also find an active, online support group at the web site of the Vascular Birthmarks Foundation.
A schedule of follow-up care will be determined by your child's physician and other members of your care team. The main purpose of these follow-up appointments will be to check on the effectiveness of the laser therapy and decide whether more treatments are necessary.
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