Laser treatment for birthmarks

  • Laser is used to treat skin birthmarks, such as brown/black spots and vascular lesions (pink or red marks caused by abnormal blood vessels). Vascular lesions include port wine stains and haemangiomas (strawberry naevus). See our fact sheets Port wine stains and Haemangiomas of infancy.

    Lasers can be used to safely remove or reduce spots, marks and lesions (areas of abnormal tissue). The laser treats the lesions by targeting blood vessels or pigment (colour). The laser does not cause permanent damage to the surrounding normal tissue.

    Why does my child need laser treatment?

    It can be helpful for young children to have birthmarks removed early in life, before any possible psychological effects or medical complications might start. School-age children can lose their confidence and suffer from low self-esteem because of marks on their face. In some cases, birthmarks may cause problems if they begin to press on important structures (e.g. the eyes or windpipe).

    What to expect with laser treatment

    Before the treatment

    A full explanation of your child's treatment will be given to you during the first consultation, before the laser treatment takes place. If there is anything you are not sure about, ask the doctor.

    During the treatment

    The pain of the laser is similar to small flicks on the skin with a rubber band. Most adults can tolerate this, but children may find it more difficult and require some anaesthetic cream or mild sedation. See our fact sheet Sedation for procedures.

    Anaesthetic cream may be used to numb the area, or mild sedation given if required. In very anxious children or when the treatment area is large, general anaesthesia may be required, and treatment will be carried out in an operating theatre. If this is the case, your child will be asleep under a light general anaesthetic. They won't feel any pain during the procedure and they won't remember it afterwards.

    Care at home

    After the laser therapy, the treated area may be sore, swollen, red or bruised. Before you go home, hospital staff will advise you what to do if this happens. Your child may need simple pain relief, such as ice packs and paracetamol. See our fact sheet Pain relief for children.

    If the area blisters, it may need antibiotic ointment or a special dressing to accelerate healing. You will be given detailed information about this following the procedure.

    Different types of lasers

    The following are laser treatments used at The Royal Children's Hospital (RCH).

    Q-Switched YAG (QSY) laser

    The QSY laser is used to treat age spots, sunburn freckles, café au lait spots and other brown/black pigmented birthmarks. The laser light is absorbed only by the cells containing extra amounts of pigment. It destroys the pigment granules (called melanosomes) but does not destroy the surrounding tissues or remove the skin's normal colour.

    V-Beam laser/Candela laser

    This laser selectively destroys the small blood vessels that cause a pink to red appearance on the skin surface, without damaging the surrounding tissue or outer layer (epidermis) of the skin. It is used to treat vascular lesions, such as port wine stains, spider veins of the face, flat strawberry haemangiomas in infants and the persistent facial redness sometimes seen in teenagers.

    There is usually some bruising around the area after treatment. This lasts about seven to 10 days. 

    GentleYAG (Long Pulsed YAG laser)

    This laser produces deeply penetrating infrared light. It is used to treat vascular birthmarks made up of blue-looking veins, or haemangiomas that do not flatten adequately before school age. There may be some temporary swelling around the area after GentleYAG treatment.

    This laser can also be used to manage excessive hair growth seen in medical conditions such as polycystic ovary syndrome. Multiple treatments are usually required.

    CO2 (carbon dioxide) ablative laser

    The CO2 ablative laser gives out an intense beam of energy that vaporises tissue instantly. It is used to sculpt down abnormal tissues that are raised above the level of the skin's surface. It is often used at the RCH to treat facial lumps (e.g. in tuberous sclerosis) and warty birthmarks, such as epidermal naevi. Raised scars are sometimes flattened down with this laser, and loose areas of scarring can be tightened.

    The CO2 laser leaves raw areas of skin that take up to 10 days to heal and require special dressings to prevent crusting and scabbing. Some children may also develop light or dark spots in the area treated. The spots usually fade with time.

    When to see a doctor

    Unless your doctor has given you different instructions, if blistering or scabbing occurs, apply petroleum jelly (e.g. Vaseline) and contact your treating doctor.

    If there are signs of infection (the area is increasingly hot, red or painful), see your doctor as your child may need antibiotic ointment to treat the affected area. Also call your doctor if the blistering and scabbing starts to bleed.

    Key points to remember

    • Lasers are used to treat many skin conditions in children, such as port wine stains or haemangiomas.
    • Laser treatment may be performed with the area numbed by an anaesthetic cream or your child may be given mild sedation. Some children require a general anaesthestic.
    • The treated area may be sore, swollen or blistered after the treatment. If you have any concerns, contact your child's treating doctor.

    For more information

    Common questions our doctors are asked

    How successful is laser treatment for port wine stains?

    For children with port wine stains who have laser treatment, the mark will lighten by about 50 per cent. For some children, the redness will almost completely go away. Unfortunately, for a few children, the laser therapy does not work at all. Most children need about four sessions, but sometimes more treatments are administered to get the best results.

    What are the risks of laser therapy?

    Risks are very low with V-beam laser treatment. It is estimated that in less than one per cent of cases tiny areas of superficial scarring may develop. In children with darker skin there is a risk of skin darkening (hyperpigmentation). Sometimes laser treatment can also leave paler areas of skin (hypopigmentation). If you are concerned, please discuss this before treatment.

    The CO2 and long-pulsed YAG lasers have a higher risk of scarring. This will be discussed before starting treatment.

    Should I put vitamin E cream on my child's skin to prevent scarring?

    There is no good evidence that Vitamin E is effective in preventing scarring due to laser treatment.


    Developed by The Royal Children's Hospital Dermatology department and Day Surgery centre. We acknowledge the input of RCH consumers and carers. 

    Reviewed August 2018. 

    Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au

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Disclaimer
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.