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

BACKGROUND. Since the pulsed dye laser (PDL) was introduced in the late 1980s the question has been raised whether one should treat congenital capillary 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 treatment needs also to be clarified. METHODS. This retrospective study includes 163 patients with PWS treated with the PDL until there was either total clearing or until there was no further improvement. When a period from a few months to 8 years had elapsed after the treatments, the patients were given a questionnaire, which had been developed in cooperation with a psychiatrist, in order to evaluate the psychosocial implications of the PWS and the consequences of treatment. RESULTS. Eighty percent of the patients more than 7 years of age had not fully 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 percent thought their PWS influenced their life in some negative way. Forty-five percent of the patients considered themselves to have a lower self-esteem than their own age group. The majority of the patients considered themselves negatively influenced by their PWS. Most psychosocial parameters, such as self-esteem, contact with the opposite sex, social relationships, school contacts, the need to cover their PWS with make-up or clothes, and meeting new people, improved significantly after PDL treatment. Older patients had higher negative scores than the younger ones, indicating the advantage of early treatment. Patients who were treated earlier with other methods producing less favorable results scored unfavorably compared to previously untreated patients. CONCLUSION. Patients with PWS treated at our clinic consider their psychosocial status to be improved after treatment. An early treatment seems to he favorable for these patients.