Pulsed Dye Laser

A pulsed dye laser (PDL) is a type of treatment that uses a laser to remove or treat various vascular anomalies. The laser emits a brief, intense pulse of light that is absorbed by blood vessels in the skin, causing them to heat up and break down.

This causes the red color in the blood vessels to fade, without damaging the rest of the skin in the area. The Vascular Anomalies Center and Dermatology Program at Boston Children’s Hospital understand how to treat vascular anomalies in children and have extensive training working with young patients.

PDL is used to treat “birthmarks” and other skin conditions in children, including:

• Port wine birthmarks (capillary malformations)
• Hemangiomas
• Spider telangiectasias

This treatment is safe for children of all ages. We always evaluate each individual child’s needs and take a customizable approach to their treatment ensure that this is the right option for them.

The PDL treatment can be performed while your child is awake in our clinic sedated, or asleep under general anesthesia in the operating room (OR). Together, you and your child’s dermatologist will determine what is the best approach for your child — our goal is make your child’s treatment as comfortable as possible for them based on their age and treatment plan.

If the decision is made to undergo PDL in the OR, your child may need an appointment in our pre-operation clinic, which is typically held on the same day. During this visit, you and your child will:

• Review important details and questions with a pre-op nurse
• Meet with an anesthesiologist, who will explain how your child is put to sleep for the procedure and review the consent process
• Undergo any necessary laboratory testing, such as blood work

There are a few safety steps to follow for the best results, including:

• Avoid direct exposure to the sun before treatment
• Avoid aspirin or aspirin-like products for 14 days before treatment
• Use sunscreen with SPF 30 or greater after the procedure

On the day of your child’s PDL treatment, we recommend arriving at the clinic at least one hour early. You and your child will check into the clinic and fill out the appropriate consent forms prior to the procedure. If you are a legal guardian and not a parent, you must bring legal paperwork with you showing proof of legal guardianship.

Once the consent process is done:

• Medication such as Tylenol® will be given to help prevent discomfort or pain
• If performed under local anesthesia (your child is awake), a numbing cream will be applied to the treatment area to minimize discomfort
• Our team will bring you and your child to the room where the procedure takes place
• If your child will be undergoing the procedure with general anesthesia, the anesthesiologist will deliver anesthesia

Pulsed dye laser treatment is an outpatient, or one-day, procedure that does not require a hospital stay.

During the procedure, the physician holds a wand against your child’s skin and pulses the laser. The experience feels like a rubber band snapping against the skin. Your child may experience a tingling or burning sensation, which usually subsides within a few hours. Additionally:

• Your child will wear eye protection, as the laser light can potentially harm the eyes.
• The treatment typically takes only a few minutes, depending on the area being treated. Larger treatment areas may take longer.
• If undergoing treatment with local anesthesia, we may not treat the entire area to prevent lidocaine toxicity.
• Treatment takes place over multiple sessions.

After your child has a PDL treatment, they should avoid direct trauma to the treatment area in the week following treatment. Your child may notice some of the following side effects after the procedure, including:

• Purple discoloration at the treatment site immediately after the procedure that may last for several days
• Mild discomfort and swelling that usually subside within a few hours

For home care, we have a useful education sheet that you can review. For any questions about post-procedure care, we are always available by phone or if you leave a message with us in your patient portal.