How Effective is Pulsed Dye Laser for Cherry Hemangiomas?

Question

What is the average number of treatments to achived desired results, and how long do the results last?

William Groff, DO · Answer

The pulsed dye laser in considered the gold standard for treatment of vascular lesions like cherry angiomas. It has an excellent safety record and can remove cherry angiomas in one treatment, unless they are very large. Other choices include

Nd:YAG
KTP lasers
IPL

Having used all of these devices, I recommend the pulsed dye laser or Nd:YAG.
Best of luck!

Nd:YAG
KTP lasers
IPL

Having used all of these devices, I recommend the pulsed dye laser or Nd:YAG.
Best of luck!

John L. Burns Jr., MD · Answer

Hemangiomas are benign (not cancerous) proliferative vascular tumors of infancy.  Generally, they are not present at birth but shortly after birth enter a 6 - 12 month growth phase.  From 12 - 24 months they stay about the same size and from 24 months to 6 - 8 years of age they gradually involute.  Hemangiomas vary widely in their clinical presentation from small, flat, self limiting lesions to large/massive, ulcerated, pedunculated tumors. 

	Treatment of hemangiomas also varies widely depending on the size and location of the hemangioma as well as the phase the hemangioma is in:  proliferative or involutional.  Hemangiomas can be treated with medication in the proliferative phase using either steroids (hydrocortisone) or Beta blockers (propranolol).  These drugs do have side effects and their use should be carefully monitored by the treating physician. 

	Hemangiomas can then be evaluated for treatment which could include a watch and wait approach, early or delayed laser therapy to minimize scar consequences, or surgery. 

	Laser treatment of hemangiomas has several advantages over traditional excisional surgery:  eliminate blood loss, safely treat a hemangioma which is involving critical structures (example facial nerve), and minimize scarring.  The goal of laser therapy is to remove disfiguring color from the hemangioma and reduce the size, making it blend with the surrounding skin as perfectly as possible.

	The pulsed dye laser is generally used to treat the red color of hemangiomas.  This laser is very superficial and penetrates only 0.7mm into the skin making it ineffective in treating the underlying mass.  The Nd:YAG laser can be used in combination with the pulsed dye laser to treat the deeper component and mass effect of the hemangioma.  Using a 5 - 7mm spot size, the Nd:YAG laser can penetrate about a 10mm.  A combination of these two lasers of most effective. 

	As with most lasers, repeat treatments are almost always necessary.  These treatment are spaced about 6 - 8 weeks apart to allow all swelling to resolve before repeating the treatment.  Photographic documentation is extremely helpful in evaluating the progess and in planning future procedures.

Raffy Karamanoukian, MD, FACS · Answer

Cherry angiomas are common and are best treated with pulse dye laser or Yag laser.  These laser target the red blood vessels and vaporize them. Downtime is minimal.

Michael H. Gold, MD · Answer

The answer is very simple — the Pulsed Dye Laser is VERY effective, and the treatment of choice for cherry hemangiomas. One or two zaps and the majority of these lesions are resolved.

Margaret Mann, MD · Answer

Cherry angiomas are small blood vessel growths that are very effectively treated with pulsed dye laser.   In fact, it is usually the standard of care in our office.   This is a very satisfying treatment and a "home run" in my office. Patients usually need only 1-2 treatments for the spots to be gone.   Once they are treated, they rare come back.  Most people who develop cherry angiomas have a tendency to develop new ones over time.

	Pulsed dye laser have been used for safely for more than 20 years in treating blood vessel birthmarks in kids. For cherry angiomas, the red spots will turn purple (bruising) after treatment then slowly fade over the next week or two. You may have some minor swelling associated with it. As with any laser treatment, there is always a minor risk of blister and scar-- but if the right settings are used, these rare, if ever, happen. 

	Best,

	Dr. Mann

Michael Contreras, MD · Answer

The pulsed dye laser targets the blood within the vessels that make up a cherry angioma. With the appropriate settings, most cherry angiomas can be treated in one setting. There will occasionally be a bruise at the treated site that resolves within 10-14 days.

Philip S. H. Hughes, MD · Answer

Cherry angiomas are common benign vascular tumors that are cosmetically a problem. The 595nm pulsed dye laser (Candela Vbeam Perfecta) is the ideal tool for non-scarring resolution of these lesions. They can be ablated at a rate of one every 2 seconds, so large numbers can be efficiently removed.

Stephen A. Goldstein, MD · Answer

The pulse dye laser has been used successfully for many years and is my first line choice for skin-vascular lesions.  The size and depth of the vascular lesion will determine how many treatments you will require.
Go to a board certified physician with a strong laser background. 
I hope this helps you!
Stephen A. Goldstein, MD, FACS

How Effective is Pulsed Dye Laser for Cherry Hemangiomas?

Answers (8)

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