Ann Plast Reconstr Surg | Volume 3, Issue 5 | Case Series | Open Access

Fractionated CO₂ Laser Treatment to Reduce Fibro-Fatty Tissue Bulk of Involuted Infantile Hemangiomas: A Case Series

Erin Good1, Anna Yasmine Kirkorian2, Nancy M Bauman1,3* and Iris K Rubin⁴

¹George Washington University School of Medicine, USA
²Division of Dermatology, Children’s National Hospital, USA
³Department of Otolaryngology, Head and Neck Surgery, Children’s National Hospital, USA
⁴Clarity Cosmetics Inc., USA

^*Correspondance to: Nancy M Bauman 

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Abstract

Importance: Involution of Infantile Hemangiomas (IH) may result in unsightly fibro-fatty bulky residuum that is difficult to treat effectively. Objective: To present the outcome of fractionated CO₂ laser treatments to improve skin texture and reduce fibro-fatty tissue of involuted IH in a pilot study of 3 pediatric patients. Design, settings and participants: Case series in which the medical records of 3 patients undergoing fractionated CO₂ laser treatments for cosmetically disfiguring involuted IH between January 2015 and March 2017 at a tertiary care pediatric hospital were reviewed to collect demographics, lesion haracteristics, prior and concomitant therapies, number of treatments, complications, pre and post treatment photos and perceived outcome. Results: Patients were 4 years of age with a 2:1 female ratio and stable involuted IH. Bulky lesions were located on the upper arm (14 × 16.5 cm² and 5 × 4 cm²), cheek (2 × 1 cm²), and upper lip (2.5 × 1.5 cm²). Patients underwent a mean of 3.3 treatments (2 to 5) over 2 to 23 months. All sessions were combined with pulsed dye laser treatment to concurrently address vascular discoloration. Parents reported a mean 70% reduction (50% to 80%) in size of residual involuted IH bulk and one parent also reported resolution of oral incompetence following lip treatment. Minor adverse events of focal crusting, erythema, mild hyperpigmentation and mild discomfort all resolved within 1 to 2 weeks. Conclusion: The fractionated CO₂ laser shows a promising novel role in the treatment of cosmetically disfiguring, bulky, fibro-fatty tissue and textural changes of involuted IH and can be combined with pulsed dye laser therapy to concomitantly reduce erythema and telangiectasias. Further studies with objective evaluation of reduction in lesion volume following fractionated CO₂ laser treatments are warranted.

Keywords:

Keywords: Infantile hemangiomas; Fractionated CO₂ laser treatment; Fibro-fatty tissue

Citation:

Good E, Kirkorian AY, Bauman NM, Rubin IK. Fractionated CO₂ Laser Treatment to Reduce Fibro-Fatty Tissue Bulk of Involuted Infantile Hemangiomas: A Case Series. Ann Plast Reconstr Surg. 2019; 3(5): 1045..