KidsMD Health Topics

Pulsed Dye Laser

  • The pulsed dye laser is a device that produces a bright light that is absorbed by abnormal blood vessels, which are destroyed without damaging the surrounding skin.

    A team approach

    Should your child's doctor recommend pulsed dye laser treatment for your child's birthmark, you'll meet with a physician at the Vascular Anomalies Center (VAC) at Boston Children's Hospital.

    Our team collaborates in the evaluation and management of patients with vascular anomalies. This team approach ensures that your child's treatment plan is carefully developed and coordinated with the expertise of our specialists in vascular anomalies and in other medical areas throughout the hospital.

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    Boston Children's Hospital
    300 Longwood Avenue
    Fegan Building, 3rd Floor
    Boston MA 02115 

    617-355-5226

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  • What kind of conditions can be treated with a pulsed dye laser?

    The commonly treated conditions include the following birthmarks:

    What's the treatment like?

    During the treatment, the physician will hold a wand against the skin and "pulse" the laser. Your child will wear eye protection because laser light can potentially harm the eyes.

    At the first session, the physician will probably test your child's skin reaction to the laser. Other sessions may be longer (up to 30 minutes) in order to treat a larger area. Some lesions (spider angiomas) may require only one or two treatment sessions, while larger lesions (port wine stains) require four to 10 sessions.

    Is the treatment painful?

    The laser light feels a bit like a rubber band snapping against the skin. There is often a tingling or burning sensation for up to six hours after treatment.

    Most adults tolerate the procedure without anesthesia. Some children may require anesthetic or medication to relax them.

    What are the side effects?

    • Immediately after the treatment, a purple discoloration appears at the treatment site. This lasts for seven to 10 days. As this color fades, the treated area may still look red, but will slowly fade to normal skin color over the next few weeks.
    • Crusting may develop in the first several days and last up to two weeks.
    • Some children may experience a temporary brown discoloration of the skin for several months.

    What precautions need to be taken before/after treatment?

    • Help your child avoid direct exposure to the sun for 3 weeks prior to the treatment. Sunburn and suntan may absorb the laser light and make the treatment less effective.
    • Treated skin may also be overly sensitive to the sun and should not be exposed for several months. A sunscreen with SPF 15 or greater is suggested.
    • Avoid aspirin and aspirin-like products for 14 days prior to treatment.
    • An antibiotic ointment and a bandage may be applied immediately after treatment.
  • Ryan's Story


    When Ryan was born, a dark red birthmark covered his left eyelid and part of his forehead. Within days, Children's dermatologist Marilyn Liang, MD, diagnosed the discoloration as a capillary malformation, a common type of birthmarksometimes called a "port wine stain" because of its purplish color.

    Port Wine Stain

    Over time, Ryan's port wine stain has slowly faded with the help of laser treatment. Every three months, he sees Dr. Liang who uses a device called a pulsed dye laser to destroy the abnormal blood vessels beneath the skin. The treatment, which usually takes about ten minutes, feels like a rubber band snapping against the skin. If anesthesia is not used, an anesthetic cream is used to numb the area being treated.

    "He doesn't like when it's happening," says Pam. "We have to hold him in place. But by the time we're in the car on the way home he's fine, unless it's a sedation treatment which takes a bit longer to recover."

    Immediately after treatment, a purple discoloration appears at the treatment site. Ava calls it "Ryan's polka dots." This discoloration lasts for about a week then slowly fades to normal skin color. To ensure the best results, Ryan must avoid the sun and wear a hat or sunscreen to prevent a tan which inhibits the laser treatment and increases the chance of side effects.

    So far, Ryan has had seven pulsed dye laser treatments and will need further sessions as he continues to grow.

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