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CLOSE UP With Roy G. Geronemus, MD


There have been widespread concerns about potential risks associated with the repetitive use of general anesthesia in children younger than three, and this has led to questions about the treatment of port wine stains in kids, but anesthesia may not be necessary. Dermatologist Roy Geronemus, MD of Laser & Skin Surgery Center of New York, discussed the results of his recent retrospective study on this issue with Practical Dermatology® magazine.

WHY IS THIS TOPIC IMPORTANT TO STUDY?
Roy G. Geronemus, MD: We made the observation in clinical practice that port wine stain birthmarks can be safely and effectively treated in early infancy without the need for general anesthesia. This observation is particularly important because of the US FDA warnings regarding multiple exposures to general anesthesia for children under the age of three and the potential impact on neurocognitive development.

DESCRIBE THE RESEARCH AND YOUR FINDINGS.
Dr. Geronemus: This is the largest study to date (n=197) on children under the age of one. Twenty six percent of the babies achieved complete clearing, and 67 percent of the patients had more than 75 percent clearing of their PWS. No scarring or pigmentary change was noted. More complete and rapid clearing than one sees in older patients was noted, supporting the concept of early intervention.

The dramatic response before the children are aware of their birthmarks will be helpful for self esteem and will minimize risks of spontaneous bleeding in future years. (The treatments were performed using the Vbeam Perfecta from Candela without topical or general anesthesia.)

WHAT IS THE NEXT STEP?
Dr. Geronemus: Next steps include follow up of these patients with additional treatments beyond the age of one to assess further improvement or clearing.