Laser

Skin blemishes that are present at birth or appear soon after are generally referred to as "birthmarks". These may be red or brown and represent an overgrowth of superficial blood vessels or pigment cells. The treatment of these birthmarks depends on the type of lesion.

These flat red marks are present at birth and will not disappear over time. Until recently, these disfiguring birthmarks were life-long problems which have the potential to thicken and become more unsightly with ageing. As the foundation director of the Laser Unit at the Royal Children's Hospital, Assoc.Prof. Bekhor has been using laser therapy to fade and, in many cases, remove these birthmarks in young children before they start school. This has enormous social implications in an unkind world. The Candela Vbeam Perfecta™ pulsed dye laser is the treatment of choice for these birthmark lesions. Young children can be treated at the Royal Children's Hospital.

Laser Dermatology offers the same laser treatments to Adults who have missed out on early intervention. We have the Candela Vbeam Prima® laser, the Flex Nordlys™ IPL (intense pulsed light) and ExcellV™ laser long pulsed Nd YAG laser. The Dermatology Laser Unit at the Royal Children's Hospital is the only specialist paediatric centre in Victoria that can offer treatment under safe general anaesthesia for children.

These are flat red birthmarks that are not present immediately at birth but appear in the first weeks of life. They birthmarks often grow and thicken rapidly and, in extreme circumstances, ulcerate. This type of haemangioma will usually disappear by 10 years of age, but may cause developmental and social problems before this. Again, Candela Prima™ pulsed dye laser is the treatment of choice to arrest the growth and thickening of these birthmarks. Laser Treatment is only successful on flat lesions, so early diagnosis and intervention of these haemangiomas is extremely important. Usually a paediatrician or Infant Welfare nurse will identify the early signs of birthmarks and refer babies to Melbourne dermatologist Assoc.Prof. Philip Bekhor, who is an experienced expert in laser treatment of birthmarks.

If a haemangioma appears on an eyelid, nose, lip or extensively over the face, this should be regarded as a medical emergency requiring urgent medical intervention. The "gold standard" of treatment is oral or topical "beta-blocker" medication. In selected cases where the birthmark is still flat, laser may be used. The key to optimum management is early intervention. Laser Dermatology prioritises seeing these little ones.

These small annoying red spots often appear in young children and can lead to teasing at school. They are caused by the dilation of a small arteriole close to the skin. Fortunately, they respond very well to laser treatment with the pulsed dye laser and usually only a single laser treatment is necessary.

Like vascular (red) birthmarks, some of these are present at birth while others appear over time. The skin colour- producing cell is known as a melanocyte and the brown colour produced is referred to as melanin. Brown birthmarks are caused by a proliferation of melanocyte cells or an increase in melanin production in a specific area. The laser treatment of choice is Q-Switched Laser. Café au lait (flat, milk coffee coloured marks) birthmarks respond in 50% of cases. Naevus of Ota and naevus of Ito usually respond well, as does Hori's naevus. Becker's naevus, unfortunately, only responds to laser treatment in a minority of cases. Usually a laser test treatment is carried out to establish whether the lesion is responsive to laser removal. The Laser Unit at the Royal Children's Hospital is the only location in Australia that can offer extensive laser treatment of brown birthmarks on children under general anaesthetic.

Congenital Melanocytic Naevi are essentially moles that appear at birth. Sometimes they can be extremely large and are known as "Bathing Trunk Naevi". These lesions rarely respond to laser treatment.

At Laser Dermatology, most birthmarks are subjected to a test treatment to establish responsiveness before proceeding to full laser treatment. In most cases, multiple laser treatments are required. As with other lasers, the sensation is that of a flick with a rubber band. Treatment under safe paediatric general anaesthetic for children with extensive birth marks is available at the Laser Unit, Department of Dermatology at the Royal Children's Hospital.

There are many laser systems used to treat birthmarks - some more appropriate than others. However, as important as the technology is the competence and experience of the medical professional operating the machine. No one laser is the answer for every problem or skin type. Expert dermatological diagnosis and correct assessment is vital. Laser Dermatology is able to offer years of laser expertise gleaned from Assoc.Prof. Bekhor's years heading the Department of Dermatology Laser Unit at the Royal Children's Hospital.