Patients with port-wine stains and their psychosocial reactions after photothermolytic treatment

BACKGROUND. Since the pulsed dye laser (PDL) was introduced in the late 198 0s the question has been raised whether one should treat congenital capilla ry malformations, commonly called port-wine stains (PWSs), early or not. OBJECTIVE. There are pros and cons, but studies have mainly emphasized the clinical treatment results. The psychosocial importance of an early treatme nt needs also to be clarified. METHODS. This retrospective study includes 163 patients with PWS treated wi th the PDL until there was either total clearing or until there was no furt her improvement. When a period from a few months to 8 years had elapsed aft er the treatments, the patients were given a questionnaire, which had been developed in cooperation with a psychiatrist, in order to evaluate the psyc hosocial implications of the PWS and the consequences of treatment. RESULTS. Eighty percent of the patients more than 7 years of age had not fu lly accepted their PWS with increasing age and 80% thought that their life would change for the better if their PWS could be eliminated. Eighty-five p ercent thought their PWS influenced their life in some negative way. Forty- five percent of the patients considered themselves to have a lower self-est eem than their own age group. The majority of the patients considered thems elves negatively influenced by their PWS. Most psychosocial parameters, suc h as self-esteem, contact with the opposite sex, social relationships, scho ol contacts, the need to cover their PWS with make-up or clothes, and meeti ng new people, improved significantly after PDL treatment. Older patients h ad higher negative scores than the younger ones, indicating the advantage o f early treatment. Patients who were treated earlier with other methods pro ducing less favorable results scored unfavorably compared to previously unt reated patients. CONCLUSION. Patients with PWS treated at our clinic consider their psychoso cial status to be improved after treatment. An early treatment seems to he favorable for these patients.