Capillary vascular malformations may cause psychosocial stress to children as they enter school age. My practice philosophy for children with port-wine stains supports the recent publication that early intervention in young infants is paramount for better clearance outcomes.1 In my clinical experience, early intervention with the large-spot, pulsed-dye laser with dynamic cooling in young infants safely and effectively leads to excellent lightening of the vascular birthmark.

Possible factors contributing to positive outcomes include higher levels of fetal hemoglobin, decreased skin thickness, and lower melanin as a competing chromophore. Early intervention also allows us to maximize the number of office-based treatments in the first year of life without the need for anesthesia.

Maintenance treatments after the first year of life are usually required with frequency being a mutual decision between the parents and the treating physician.

The patient was treated with Vbeam Prima (Candela), an upgraded Vbeam 595nm pulsed-dye laser (PDL) with an additional 1064nm wavelength that is an efficient and versatile tool for the treatment of vascular, pigmented, and certain non-pigmented lesions on the face and body. The Vbeam Prima offers a variety of new features, including increased maximum fluence and larger spot size, which enables fast and efficient treatment of some of the most popular indications like rosacea, spider veins, and photoaging. The patient is shown at one month, four months, and after treatment. She is also shown with Dr. Friedman.