Treating childhood haemangiomas (birthmarks made up of a mass of blood vessels) with pulsed dye laser (PDL) is no better than a wait-and-see strategy.
Of 121 children aged 1-14 weeks with uncomplicated haemangiomas randomised to either PDL or no treatment, 42 per cent in the PDL group and 44 per cent in the untreated group showed complete resolution, or only minimal residual signs, after one year. The proportion of parents who felt the haemangioma was still a problem was 18 and 15 per cent, respectively.
Although the number of complications was similar in both groups, infants treated with PDL were more likely to have skin atrophy (28 vs 8 per cent) and hypopigmentation (45 vs 15 per cent). The only feature to improve with PDL was redness.
Even when started early, as is often advised, many children needed repeat treatments to control proliferation, resulting in a considerable investment by parents in both time and money (Lancet, 2002; 360: 521-7).