Comparative evaluation of laser therapy for infantile hemangiomas: A systematic review of clinical outcomes and treatment considerations

Abstract

Background and objectives

Infantile hemangiomas (IHs) are the most common benign vascular tumors in infancy. While many resolve spontaneously, treatment is often required due to ulceration, functional impairment, or aesthetic concerns. Laser therapy, either alone or in combination with beta-blockers, has become a central therapeutic option. However, optimal laser parameters, efficacy for different IH types, and safety remain under investigation. This systematic review evaluates the effectiveness and safety of various laser treatments for IHs, focusing on lesion regression, treatment protocols, recurrence, and adverse events.

Study design/materials and methods

A systematic search was conducted following PRISMA guidelines in PubMed, Scopus, Web of Science, Embase, and the Cochrane Library. Studies published up to January 2025 were included. This review included 20 studies comprising a total of 2856 patients. Included clinical studies evaluated laser therapy—alone or combined with pharmacological agents—and reported outcomes such as lesion regression, treatment duration, recurrence, and adverse effects.

Results

The 595-nm pulsed dye laser (PDL) was the most studied and showed high efficacy for superficial IHs, with improvement rates up to 85 %. The 1064-nm Nd:YAG laser was more effective for deeper lesions, achieving up to 87.57 % regression. Combination therapies (e.g., PDL with propranolol or timolol) yielded better outcomes than monotherapy, with higher regression and lower recurrence. Dual-wavelength approaches also showed promise. Adverse effects were generally mild and infrequent.

Conclusion

Laser therapy is effective and well-tolerated for IHs. PDL is preferred for superficial lesions and Nd:YAG for deeper or mixed types. Standardized protocols are needed, and further research should refine therapeutic parameters and clinical guidelines.