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-   -   Questions re: duration, effectiveness of laser treatment (http://birthmark.org/board/showthread.php?t=2598)

oprichard 10-09-2007 04:13 PM

Questions re: duration, effectiveness of laser treatment
 
Hello. My infant daughter was born with a light PWS on her cheek going up toward her ear. There was no nervous system complication, thank God.

She is now almost eight months old and has received three laser treatments in the past months, the most recent being about three weeks ago. My wife and I have been unable to determine whether the PWS has faded at all. Sometimes I think it may have lightened a touch, but I fear that I am simply reading in to what I so desperately want to see.

Our fourth visit to the laser doctor is later this month. So far, the dermatologist has been pretty noncommittal as far as her prognosis. She will only say that each case is different and that they typically like to evaluate progress after sets of three laser sessions.

Understanding that each case is different, I am wondering:

1. Is improvement typically visible after after the first few treatments, or does it sometimes take several more times under the laser before significant lightening takes place?

2. Would improvement typically be visible immediately after the bruising subsides, or is there residual fading of the PWS that takes place in the days/weeks after the trauma from the laser goes away?

3. How many treatments without notable improvement might a doctor order before the laser treatments are abandoned? And if laser doesn't work, is there another course of treatment to pursue? Typically, how successful are these types of treatments?

I know there are no uniform answers to these questions, but any experiences people can share would be much appreciated. If the laser treatment is not going to work, I want to accept that and move on.

Thanks!

Dahon 10-10-2007 01:51 PM

I'm not sure what laser you are using? Is your doctor using a Vbeam laser? There's another Cynergy laser made by Cynosure that some people say are better for certain PWS.

I saw some lightening of my PWS with the first laser Vbeam treatment. Although it was little, I saw some improvement.

I was told that it could take anywhere from 3-8 treatments to remove a PWS and there is no guarantee of full removal. Also, some people do touch ups every year or other year to prevent the PWS from coming back.

nickbar 10-10-2007 08:28 PM

. Is improvement typically visible after after the first few treatments, or does it sometimes take several more times under the laser before significant lightening takes place? Some doctors are much more conservative with laser tx. than others...it depends on their experience and type of laser. Laser treatment is most effective when the laser type and settings are customized for your child's specific pws (depth, size etc). You should be seeing some improvement by now in my opinion.


2. Would improvement typically be visible immediately after the bruising subsides, or is there residual fading of the PWS that takes place in the days/weeks after the trauma from the laser goes away? The results of the laser tx can be seen within 10 days of treatment typically. Yes...when the purpula fades.

3. How many treatments without notable improvement might a doctor order before the laser treatments are abandoned? And if laser doesn't work, is there another course of treatment to pursue? Typically, how successful are these types of treatments? I would encourage you to seek the advice of Dr. Stuart Nelson (you can find him in the ask the expert section of the main page). He can give you a better idea of what options are available for your child and how to maximize the light into the pws.

Good luck and keep us posted.

robolynn29 10-18-2007 03:06 AM

Thought I would post just from my daughter's experience. I'm sure there are better medical opinions out there though.

1. Is improvement typically visible after after the first few treatments, or does it sometimes take several more times under the laser before significant lightening takes place? My daughter's face is more stubborn than the rest of her body regarding the results of treatment. Her doctor has said it is a case by case result as well. I always take pictures so I can do comparisons. Much of her face is lighter than before, but there are still stubborn areas. Her doctor is using a Vbeam.

2. Would improvement typically be visible immediately after the bruising subsides, or is there residual fading of the PWS that takes place in the days/weeks after the trauma from the laser goes away? It takes about 3-4 weeks for us to see the result of the previous treatment. Some areas up to 6 weeks (like her legs and hands), but then all of a sudden you notice whiter areas.

3. How many treatments without notable improvement might a doctor order before the laser treatments are abandoned? And if laser doesn't work, is there another course of treatment to pursue? Typically, how successful are these types of treatments? This is case by case and doctors are different. Our doctor said she would go as long as we needed her to as long she saw steady improvement. Once we reach the best case scenario with the vbeam, we might look into other options available.


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