What is Laser Treatment for Hemangioma?
An Effective and Safe Option


Hemangioma is one of the most common benign vascular tumors, especially in infants. These lesions, which are usually noticed at birth or in the first weeks after birth, are seen at a rate of 3-4%. Although they usually regress spontaneously, treatment may be required in some cases. In recent years, laser treatment has emerged as an effective, safe and minimally invasive method in the treatment of hemangiomas.

What is Hemangioma and Who Sees It?
Hemangiomas occur with the uncontrolled proliferation of endothelial cells that form the vessels. There are different subtypes, including capillary, cavernous and telangiectatic. The most common form is infantile hemangioma.

It is more common in premature babies, those with low birth weight and babies of mothers who give birth at an advanced age. Lesions can be superficial, deep or mixed in structure, containing both components.

Stages of Hemangiomas
Hemangiomas are examined in three stages according to their biological behavior:

Proliferative Stage (First 8-12 months): Rapid growth stage.

Involution Stage (1-12 years): The regression process begins with fibrosis and increased fat tissue.

Residual Stage: Erythema and telangiectasias may remain in the place of the lesion that has decreased in size.

In Which Cases Is Treatment Required?
Most hemangiomas regress over time. However, intervention may be required in the following cases:

Location that prevents vital functions (eye, ear, nose, genital area)

Respiratory risk due to airway involvement

Large facial lesions that will impair appearance

Ulcered or infected lesions

Systemic involvement

Remaining skin changes after involution (erythema, telangiectasia)

Place and Importance of Laser Treatment
Laser treatment is used to control the growth of hemangiomas both in the proliferative phase and to reduce the scars left after involution. The most commonly used laser type is the PDL (Pulsed Dye Laser) system.

Target of Laser: Oxyhemoglobin
Laser systems act by targeting oxyhemoglobin in the vessel. Laser beams with wavelengths of 585-600 nm destroy the vascular tissue through selective photothermolysis, while not harming the surrounding healthy tissue.

Which Laser Systems Are Used?
1. Pulsed Dye Laser (PDL)
Works at a wavelength of 585-595 nm.

Very effective in superficial lesions.

Growth can be controlled especially when treatment is started early.

Treatment can be planned between 2-12 sessions.

It has few side effects; temporary conditions such as hyperpigmentation and crusting can be seen.

2. Nd:YAG Laser
It penetrates deeper lesions better.

It is less preferred than PDL.

It can be included in combined treatments.

3. Combined Laser Protocols
The sequential use of PDL and Nd:YAG laser allows simultaneous intervention in lesions at different depths. Success rates over 70% have been reported in studies.

Is the Timing of Laser Treatment Important?
Yes. The earlier laser treatment is started, the easier it is to control growth. However, since most patients apply to dermatology clinics in the proliferative phase, i.e. the period of rapid growth, this timing should be adjusted well.

Combined Methods with Laser Treatment
It has been reported in the literature that laser treatment is more effective when used together with topical propranolol or systemic treatments. These combined approaches may be preferred especially in large lesions.

Risks and Side Effects of Laser Treatment
Although it is generally safe, the following side effects may be seen in some cases:

Temporary hypopigmentation or hyperpigmentation on the skin

Crusting or erosion

In rare cases, herpes activation, infection, excessive granulation or pyogenic granuloma

Follow-up without Treatment or Laser?
Although some studies suggest that there is no long-term difference between babies who are followed up without treatment and those who receive PDL, many studies emphasize that laser treatment is especially beneficial in the early stages. Early treatment is recommended instead of waiting, especially in lesions with a risk of ulceration or causing aesthetic concerns.

Conclusion: Laser is an Effective and Safe Option in Hemangioma Treatment
Hemangiomas are lesions that often regress on their own. However, in some cases, they must be treated. Laser treatment, as a minimally invasive method; It is an important tool for both controlling growth and improving skin appearance.

Pulse Dye Laser (PDL) systems in particular are successfully used in superficial hemangiomas; when necessary, it can be combined with deep-acting systems such as Nd:YAG laser.

Laser applications performed at the right time and with the right method can significantly increase the quality of life of both children and parents.