Evaluation of argon laser surgery in children under 13 years of age.

Argon laser surgery is an effective treatment for ectasias and congenital port-wine stains; however, its use in children under the age of 13 is controversial. This paper reviews 202 children under the age of 13 who underwent argon laser treatments for congenital port-wine stains, spider angiomas, epidermal nevi, and lentigines. The clinical characteristics of port-wine stains in 170 children are discussed. Good to excellent results (moderate to complete clearing) in port-wine stains were obtained in 60 percent of patients and seemed to correlate best with lack of blanchability on pressure. Hypertrophic scarring was seen in only 7 children, all of whom had undressed wounds; no significant scarring has been seen in any subsequent child who had maintained a dressed wound postoperatively.

Laser surgery for children.

Laser surgery can be effectively used in children with either local or general anesthesia. The laser must be used only in selected instances where other therapies have not been fruitful, such as congenital port-wine stains or recalcitrant warts. Significant scarring is a potential sequela of the second degree burns produced by argon or carbon dioxide laser surgery, and is particularly a risk for children. Elective laser surgery, therefore, should be deferred until a child would be capable of cooperating fully with postoperative wound care. Parents must be appropriately informed about expectations for cure in certain diseases which may be only partially remedied. For instance, congenital melanocytic nevi may be improved, but are incompletely removed by laser surgery. Also, dramatic improvements in dynamic diseases such as adenoma sebaceum may represent only a temporary interlude.