Abstract
Advances in laser therapy have led to novel therapeutic approaches to common pediatric skin conditions. As a non-invasive alternative to surgical options, laser therapy is efficacious in treating a broad range of conditions, from vascular and pigmented lesions to tattoo and hair removal. This paper reviews the basic mechanics of laser therapy, its role in common pigmented pediatric dermatoses, and special considerations for this unique age group.
Similar content being viewed by others
References
Cantatore JL, Kriegel DA. Laser surgery: an approach to the pediatric patient. J Am Acad Dermatol. 2004;50(2):165–84.
Cordisco MR. An update on lasers in children. Curr Opin Pediatr. 2009;21(4):499–504.
Anderson RR. Lasers for Dermatology and Skin Biology. J Invest Dermatol. 2013;133:E21–3.
Cole PD, Sonabend ML, Levy ML. Laser treatment of pediatric vascular lesions. Semin Plast Surg. 2007;21(3):159–66.
Tanzi EL, Lupton JR, Alster TS. Lasers in dermatology: four decades of progress. J Am Acad Dermatol. 2003;49(1):1–31.
Welch AJ, Torres JH, Cheong WF. Laser physics and laser-tissue interaction. Tex Heart Inst J. 1989;16(3):141–9.
Anderson RR, Parrish JA. The optics of human skin. J Invest Dermatol. 1981;77(1):13–9.
Anderson RR, Parrish JA. Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science. 1983;220(4596):524–7.
Kasai K. Picosecond Laser Treatment for Tattoos and Benign Cutaneous Pigmented Lesions (Secondary publication). Laser Ther. 2017;26(4):274–81.
Allemann IB, Goldberg DJ (eds). Basics in Dermatological Laser Applications. Basel, Switzerland: Karger Medical and Scientific Publishers; 2011.
Patil UA, Dhami LD. Overview of lasers. Indian J Plast Surg. 2008;41(3):101–13.
Stratigos AJ, Dover JS, Arndt KA. Laser treatment of pigmented lesions–2000: how far have we gone? Arch Dermatol. 2000;136(7):915–21.
Chapas AM, Geronemus RG. Our approach to pediatric dermatologic laser surgery. Lasers Surg Med. 2005;37(4):255–63.
Chapas AM, Eickhorst K, Geronemus RG. Efficacy of early treatment of facial port wine stains in newborns: A review of 49 cases. Lasers Surg Med. 2007;39(7):563–8.
Ashinoff R, Geronemus RG. Flashlamp-pumped pulsed dye laser for port-wine stains in infancy: Earlier versus later treatment. J Am Acad Dermatol. 1991;24(3):467–72.
Ducharme EE, Silverberg NB. Selected Applications of Technology in the Pediatric Dermatology Office. Semin Cutan Med Surg. 2008;27(1):94–100.
Lillieborg S, Otterbom I, Ahlen K. Topical anaesthesia in neonates, infants and children. Br J Anaesth. 2004;92(3):450–1.
Chiang YZ, Al-Niaimi F, Madan V. Comparative Efficacy and Patient Preference of Topical Anaesthetics in Dermatological Laser Treatments and Skin Microneedling. J Cutan Aesthet Surg. 2015;8(3):143–6.
Gonzalez ME, Connelly EA, Schachner L. Techniques to allay anxiety during pediatric laser procedures. Arch Dermatol. 2008;144(11):1476.
Belkin DA, Jeon H, Weiss E, Brauer JA, Geronemus RG. Successful and safe use of Q-switched lasers in the treatment of nevus of Ota in children with phototypes IV–VI. Lasers Surg Med. 2018;50(1):56–60.
Jevtovic-Todorovic V. Anesthetics and cognitive impairments in developing children what is our responsibility? JAMA Pediatr. 2017;171(12):1135–6.
Chan HH, Leung RSC, Ying SY, et al. A retrospective analysis of complications in the treatment of nevus of Ota with the Q-switched alexandrite and Q-switched Nd:YAG lasers. Dermatol Surg. 2000;26(11):1000–6.
Jerdan K, Hsu JT, Schnurstein E. Successful treatment of Ota nevus with the 532-nm solid-state picosecond laser. Cutis. 2017;99(3):E29–31.
Levin MK, Ng E, Bae YSC, Brauer JA, Geronemus RG. Treatment of pigmentary disorders in patients with skin of color with a novel 755 nm picosecond, Q-switched ruby, and Q-switched Nd:YAG nanosecond lasers: A retrospective photographic review. Lasers Surg Med. 2016;48(2):181–7.
Ohshiro T, Ohshiro T, Sasaki K, Kishi K. Picosecond pulse duration laser treatment for dermal melanocytosis in Asians : A retrospective review. Laser Ther. 2016;25(2):99–104.
Chesnut C, Diehl J, Lask G. Treatment of nevus of ota with a picosecond 755-nm alexandrite laser. Dermatol Surg. 2015;41(4):508–10.
Seo HM, Choi CW, Kim WS. Beneficial effects of early treatment of nevus of ota with low-fluence 1,064-nm Q-switched Nd:YAG laser. Dermatol Surg. 2015;41(1):142–8.
Alora MB, Arndt KA. Treatment of a café-au-lait macule with the erbium:YAG laser. J Am Acad Dermatol. 2001;45(4):566–8.
Artzi O, Mehrabi JN, Koren A, Niv R, Lapidoth M, Levi A. Picosecond 532-nm neodymium-doped yttrium aluminium garnet laser—a novel and promising modality for the treatment of café-au-lait macules. Lasers Med Sci. 2018;33(4):693–7.
Somyos K, Boonchu K, Somsak K, Panadda L, Leopairut J. Copper vapour laser treatment of cafe-au-lait macules. Br J Dermatol. 1996;135(6):964–8.
Chung BY, Han SS, Moon HR, Lee MW, Chang SE. Treatment with the pinhole technique using erbium-doped yttrium aluminium garnet laser for a café au lait macule and carbon dioxide laser for facial telangiectasia. Ann Dermatol. 2014;26(5):657–9.
Balaraman B, Ravanfar-Jordan P, Friedman PM. Novel use of non-ablative fractional photothermolysis for café-au-lait macules in darker skin types. Lasers Surg Med. 2017;49(1):84–7.
Nakayama J, Kiryu H, Urabe K, et al. Vitamin D3 analogues improve cafe au lait spots in patients with von Recklinghausen’s disease: Experimental and clinical studies. Eur J Dermatol. 1999;9(3):202–6.
Lahti JG, Shabshin U, Lewis AT, Benedetto AV. Pediatric cosmetic dermatology. Clin Dermatol. 2003;21(4):315–20.
Wang Y, Qian H, Lu Z. Treatment of café au lait macules in Chinese patients with a Q-switched 755-nm alexandrite laser. J Dermatolog Treat. 2012;23(6):431–6.
Belkin DA, Neckman JP, Jeon H, Friedman P, Geronemus RG. Response to laser treatment of café au lait macules based on morphologic features. JAMA Dermatol. 2017;153(11):1158–61.
Alster TS. Complete elimination of large cafe-au-lait birthmarks by the 510-nm pulsed dye laser. Plast Reconstr Surg. 1995;96(7):1660–4.
Kim HR, Ha JM, Park MS, et al. A low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminium garnet laser for the treatment of café-au-lait macules. J Am Acad Dermatol. 2015;73(3):477–83.
Baek JO, Park IJ, Lee KR, et al. High-fluence 1064-nm Q-Switched Nd:YAG laser: Safe and effective treatment of café-au-lait macules in Asian patients. J Cosmet Dermatol. 2018;17(3):380–4.
Pinto F, Große-Büning S, Karsai S, et al. Neodymium-doped yttrium aluminium garnet (Nd:YAG) 1064-nm picosecond laser vs. Nd:YAG 1064-nm nanosecond laser in tattoo removal: a randomized controlled single-blind clinical trial. Br J Dermatol. 2017;176(2):457–64.
Rho N-K. Treatment of café-au-lait Macules using a Q-switched Laser Followed by Serial Fractional thulium Laser treatments. Med Lasers. 2017;6(1):41–3.
Eggen CAM, Lommerts JE, van Zuuren EJ, Limpens J, Pasmans SGMA, Wolkerstorfer A. Laser treatment of congenital melanocytic naevi: a systematic review. Br J Dermatol. 2018;178(2):369–83.
Ibrahimi OA, Alikhan A, Eisen DB. Congenital melanocytic nevi: Where are we now? Part II. Treatment options and approach to treatment. J Am Acad Dermatol. 2012;67(4):515.e1–13.
Rogers T, Krakowski AC, Marino ML, Rossi A, Anderson RR, Marghoob AA. Nevi and lasers: Practical considerations. Lasers Surg Med. 2018;50(1):7–9.
August PJ, Ferguson JE, Madan V. A study of the efficacy of carbon dioxide and pigment-specific lasers in the treatment of medium-sized congenital melanocytic naevi. Br J Dermatol. 2011;164(5):1037–42.
Bray FN, Shah V, Nouri K. Laser treatment of congenital melanocytic nevi: a review of the literature. Lasers Med Sci. 2016;31(1):197–204.
Maize JC, Foster G. Age-related changes in melanocytic naevi. Clin Exp Dermatol. 1979;4(1):49–58.
Adatto MA, Amir R, Bhawalkar J, et al. New and advanced picosecond lasers for tattoo removal. Curr Probl Dermatol. 2017;52:113–23.
Luebberding S, Alexiades-Armenakas M. New tattoo approaches in dermatology. Dermatol Clin. 2014;32(1):91–6.
Choi MS, Seo HS, Kim JG, et al. Effects of picosecond laser on the multi-colored tattoo removal using Hartley guinea pig: A preliminary study. PLoS One. 2018;13(9):e0203370.
Ho SGY, Goh CL. Laser Tattoo Removal: A Clinical Update. J Cutan Aesthet Surg. 2015;8(1):9–15.
Naga LI, Alster TS. Laser Tattoo Removal: An Update. Am J Clin Dermatol. 2017;18(1):59–65.
Weiss ET, Geronemus RG. Combining fractional resurfacing and Q-switched ruby laser for tattoo removal. Dermatol Surg. 2011;37(1):97–9.
Vangipuram R, Hamill SS, Friedman PM. Perfluorodecalin-infused patch in picosecond and Q-switched laser-assisted tattoo removal: Safety in Fitzpatrick IV–VI skin types. Lasers Surg Med. 2019;51(1):23–6.
Kossida T, Rigopoulos D, Katsambas A, Anderson RR. Optimal tattoo removal in a single laser session based on the method of repeated exposures. J Am Acad Dermatol. 2012;66(2):271–7.
Jones A, Roddey P, Orengo I, Rosen T. The Q-switched ND:YAG laser effectively treats tattoos in darkly pigmented skin. Dermatol Surg. 1996;22(12):999–1001.
Casanova D, Bardot J, Aubert JP, Andrac L, Magalon G. Management of nevus spilus. Pediatr Dermatol. 1996;13(3):233–8.
Grevelink JM, Gonzalez S, Bonoan R, Vibhagool C, Gonzalez E. Treatment of nevus spilus with the Q-switched ruby laser. Dermatol Surg. 1997;23(5):365–9.
Abrusci V, Benzecry V. Medium-sized nevus spilus of the neck treated with pulsed dye laser. Dermatol Ther. 2017;30(4):e12497.
Kagami S, Asahina A, Watanabe R, et al. Treatment of 153 Japanese patients with Q-switched alexandrite laser. Lasers Med Sci. 2007;22(3):159–63.
Trelles MA, Allones I, Moreno-Arias GA, Vélez M. Becker’s naevus: A comparative study between erbium: YAG and Q-switched neodymium:YAG; clinical and histopathological findings. Br J Dermatol. 2005;152(2):308–13.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Funding
No funding was received for the preparation of this review.
Conflict of interest
Priyanka D. Patel, Girish C. Mohan, Tanya Bhattacharya, Ronak A. Patel, and Maria Tsoukas have no conflicts of interest to disclose.
Rights and permissions
About this article
Cite this article
Patel, P.D., Mohan, G.C., Bhattacharya, T. et al. Pediatric Laser Therapy in Pigmented Conditions. Am J Clin Dermatol 20, 647–655 (2019). https://doi.org/10.1007/s40257-019-00449-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40257-019-00449-3