POTENTIAL PSYCHOLOGICAL BENEFITS FROM EARLY TREATMENT OF PORT-WINE STAINS IN CHILDREN

There is a commonly held conception among referring doctors that very small children with congenital capillary malformations, so-called port -wine stains (PWS), should not be treated until they are older. Our ex perience leads us to believe that the flashlamp pulsed dye laser is a safe and effective treatment even for infants. We have not encountered any persistent pigmentation changes, post-treatment scarring or other adverse effects. It is important to quantify the psychological disabi lities associated with this disorder to assess the need for and the be nefits of treatment. Questionnaires were distributed to 259 patients a nd their families who visited our clinic because of their PWS, Patient s who were on the waiting list for laser treatment, undergoing treatme nt or had completed their treatment received different questionnaires. The response rate was 89%. High emotional distress was encountered. D uring the age period 10-20 years, 73% (125 patients) were most disturb ed by their PWS. That the PWS influenced their life negatively was exp erienced by 75% (171 patients), and 62% (106 patients) were convinced that their life would change radically if their PWS could be eliminate d, Suffering from low self-esteem (in comparison with the same age gro up) was reported by 47% (87 patients). The PWS made their school life and education more difficult according to 28% (51 patients) of the sam ple. Of the families of patients, 76% (106 relatives) considered the p atient to be negatively affected in some way by the PWS. After the las er treatment, all of these distress parameters were significantly reli eved, together with a need to cover their PWS, their fear of going int o conflict or quarrels, their social relationships, problems with the opposite sex, rage attacks, depressions and abnormal reactions from th eir peers. We believe there is potential psychological benefit in star ting the treatments of PWS (including non-facial) at as early an age a s possible.