CO2 Laser Treatment

CO2 laser treatment is a minimally invasive therapeutic approach to treat specific skin changes associated with a type of vascular anomaly called lymphatic malformations. This treatment uses heat from the laser to evaporate several layers of the affected skin, revealing new skin that will scar and heal. A specially trained doctor called an interventional radiologist performs CO2 laser treatment.

We use several types of laser treatments for patients we see in our Vascular Anomalies Center. The CO2 laser is a higher-energy tool capable of penetrating deeper into layers of the skin than other types of lasers. Our interventional radiology team was the first in the world to adapt the CO2 laser for the treatment of lymphatic malformations, a groundbreaking development that is now a common practice here at Boston Children’s.

Children who undergo laser treatment benefit from improved quality of life with fewer infections and bleeding episodes. We recommend CO2 laser treatment for:

• Lymphatic malformations
• CLOVES syndrome
• Klippel-Tranaunay syndrome

We have no age restrictions for CO2 laser treatment. We recommend it for infants, children, and adolescents of all ages based solely on need. The procedure may be repeated as many times as needed and is often combined with other procedures done in Interventional Radiology.

Read more about what to expect before, during, and after the procedure.

Your child’s care team will provide tips for preparing your child. In addition, you may want to:

• Tell your child in simple terms why CO2 laser treatment is necessary and what will happen
• Assure your child you will be close by during the procedure
• Bring your child’s favorite toy or blanket to the hospital
• Pack loose-fitting clothing for your child to wear home after the treatment

Before undergoing CO2 laser treatment, your child may need an appointment in our pre-op clinic. During this visit, you will:

• Review important details and questions with a pre-op nurse
• Meet with the interventional radiologist who will explain the procedure and review the consent process
• Meet with an anesthesiologist who will explain anesthesia during the procedure and review the consent process
• Undergo any necessary laboratory testing, such as blood work

Consent is a necessary step before the procedure may begin. Get answers to frequently asked questions for consenting to tests, treatments, and procedures. Once the consent process is complete your child will change into a hospital gown. Our team will bring you and your child to the room where the procedure takes place, and the anesthesiologist will deliver anesthesia through an IV to help your child relax. (Young children may receive the medicine through a mask.)

You may be able stay in the room until your child is asleep; however, during the procedure, you will wait in a special area until we move your child to the post-anesthesia care unit (PACU).

For some patients, CO2 laser treatment is an outpatient, or one-day, procedure that does not require a hospital stay. Patients undergoing multiple treatments on the same day may require an overnight stay.

There are no major complications associated with CO2 laser treatment, but it will take time for your child’s skin to fully heal. Your child’s recovery period depends on the size of the area we treat.

It’s important to understand that your child’s skin will be open during recovery and require daily dressing changings. Before you leave the hospital, a nurse practitioner will teach you what to do and answer any questions you may have.

CO2 laser treatment tends to be less painful than other skin treatments because the laser actually evaporates the skin and nerve endings. We may prescribe medication to help manage pain, but many patients do not end up using it.

Our team will ask you to follow up with us weekly by email or telephone until your child’s skin heals. We will also schedule an office visit six to eight weeks after the procedure.

In cases where patients do not live close to Boston Children’s, we may partner with a physician in your community to monitor recovery.