Optimizing Laser Therapy for Vascular Anomalies: Why Early Multidisciplinary Care Matters

Lisa M. Arkin, MD, associate professor and director of pediatric dermatology at the University of Wisconsin, Madison, emphasized the importance of collaboration between pediatric dermatologists and laser surgeons in treating vascular anomalies at the 2025 American Academy of Dermatology Annual Meeting.¹ In an interview with Dermatology Times, she said that bringing together specialists with different perspectives is essential for developing more precise, effective treatments for young patients.

Arkin highlighted that vascular anomalies require a multidisciplinary approach, as no single treatment modality works for all cases. Although laser therapy generally works well for port wine birthmarks, she told Dermatology Times that other vascular anomalies often require a combination of treatments, including systemic therapies like propranolol for infantile hemangiomas. She stressed the importance of building a network of colleagues across specialties to ensure the best patient outcomes.

“The first step is really to build your village,” she told Dermatology Times. “You want a village of other folks who can help with systemic therapy or procedural interventions, propranolol for infantile hemangiomas. And then you want to get a community of laser surgeons who can help you if you're new to treating with laser, because there are a lot of pitfalls that can happen in these.”

One of the key points Arkin discussed was the importance of early intervention.² She told Dermatology Times that there is strong evidence supporting the benefits of treating port wine birthmarks early, as laser therapy is most effective when the skin is thinner and has less melanin, allowing better light penetration. She encouraged dermatologists to refer patients as soon as possible to maximize treatment success.

For infantile hemangiomas, Arkin advised that laser treatment should not be overlooked once the lesions are stabilized on systemic therapy. However, she cautioned that clinicians must be vigilant for warning signs such as early ischemia, which can indicate ulceration risk. Thoughtful and strategic treatment planning is essential to avoid complications, Arkin added.

When treating complex vascular anomalies, Arkin explained that selecting the appropriate laser wavelength is critical. Factors such as lesion depth, dominant chromophore, and energy levels must be carefully balanced to achieve optimal results, she told Dermatology Times. She stressed that laser therapy should be integrated into a broader treatment strategy rather than viewed as a standalone solution.

Ultimately, Arkin underscored that pediatric dermatologists and laser surgeons working together can significantly improve patient outcomes. “I think pediatric dermatologists and laser surgeons working together will improve outcomes for our patients,” she told Dermatology Times. “And in some ways, we want to see the world from different perspectives. So being able to negotiate and navigate and listen to other perspectives, it's going to bring the field forward… Collaboration is key.”

References

1. Arkin LM. Critical Gaps and Controversies in Laser Treatment of Port Wine Birthmarks and other Vascular Anomalies. Presented at the 2025 AAD Annual Meeting; March 7-11; Orlando, Florida.

2.Geronemus RG, Duerr HA. Early Intervention for Port-Wine Stains. Dermatology Times. March 9, 2025. Accessed March 9, 2025. https://www.dermatologytimes.com/view/early-intervention-for-port-wine-stains