Pulse dye laser treatments change children’s lives

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Eight-year old Duncan Rutherford loves getting his “spots.” Every two months the grade two Toronto student undergoes a 20-minute laser treatment at Rouge Valley Health System’s (RVHS) Centenary hospital campus.

The treatments help to significantly fade the large red discolouration of the skin, which covers the entire surface of his face and parts of his arm and back. He’s been undergoing the procedure since he was just weeks old. After the procedure, the laser leaves little round bruises on the areas of his skin that have been treated. For Duncan, the “spots,” as he calls them, are his badges of honour.

The birthmark, called a hemangioma or a port-wine stain, is the result of malformed blood vessels that create a reddish-purplish discoloration of the skin. Early port-wine stains, which first appear in babies a few days after their birth, are usually flat and pink in appearance. As a child gets older, the color may deepen to a dark red or purplish color. They usually occur on the face, but can appear anywhere on the body.

Port-wine stains occur in about three of 1,000 people, and in some cases may be a sign of Sturge-Weber syndrome, a rare disorder that may include seizures and glaucoma. Some children also have learning disabilities as a result of the seizures. The birthmark is what caused doctors to further investigate, and eventually diagnose Duncan with Sturge-Weber as an infant.

“Because of the vastness of his birthmark, his treatment began immediately,” explains Alison Gadsby, Duncan’s mother.

Since first beginning the regular laser treatments as an infant, Duncan’s port-wine stain has faded significantly. Laser therapy has been the most successful at lightening port-wine stains. A V-Beam pulse dye laser is used to destroy or shrink the tiny blood vessels in the skin without significantly damaging the skin. While it may leave temporary bruising, it doesn’t change the skin’s texture.

RVHS is one of only two hospitals in Ontario to offer the procedure. More than 500 pulse dye laser treatments are done each year at Rouge Valley Centenary. The procedure is covered under OHIP for children, who are referred for the specialized treatment by their family physicians.

For many children like Duncan, treatment of the port-wine stain can have a positive impact on how well they socialize with their classmates. “Although he has a great personality and all the kids love him, starting school with a lighter birthmark certainly helped him socially,” explains his mother Alison

“In the past, there were hardly any procedures available to help treat this condition. The disease is often associated with a lot of social stigma,” says Dr. Mansour Bendago, division head of plastic surgery at RVHS, and Duncan’s physician. “Many children are teased, and as a result, shut down emotionally. So for us to offer this type of procedure, we are able to affect many lives in a very positive way.”

Dr. Bendago is one of three physicians to offer the procedure at Rouge Valley. Plastic surgeons Dr. Marietta Zorn and Dr. Colin Hong also do the procedure, and are committed to the growth of this program.

The service at RVHS is also unique because children are treated under general anesthetic. While teens can tolerate the procedure well under local anesthetic, many younger children become anxious and find the experience too stressful. With specialized general anesthesia, children like Duncan can be awake and alert within just 20 minutes of the procedure.

A new laser at RVHS recently purchased for the program is expected to improve the quality of the treatment by minimizing the bruising. “This new laser is important because it treats the condition, to which no other treatment is available. It’s the gold standard of care,” explains Dr. Bendago.