Pyogenic granuloma (PG), commonly found among children, often leads to recurrent bleeding and discomfort. A recent study conducted at the Department of Plastic and Reconstructive Surgery evaluated two minimally invasive treatments: the long pulsed 1064 nm Nd:YAG laser and sclerotherapy. The findings reveal each treatment's efficacy and side effects, offering guidance for clinical decisions.
PG is characterized by benign vascular lesions of the skin and mucous membranes. Though treatment options have traditionally included surgical excision, the associated trauma and recovery time have resulted in the exploration of alternative methods. This retrospective study, which took place from June 2022 to March 2024, included 72 children diagnosed with PG who underwent either Nd:YAG laser treatment or sclerotherapy.
The results indicated no significant difference between the two treatments concerning overall efficacy. Initially, the Nd:YAG laser group exhibited a cure rate of 53.7% after one treatment and 78.0% after two treatments, compared to 61.3% and 83.9% for sclerotherapy, respectively. While both methods achieved high efficacy rates, the difference was not statistically significant.
Interestingly, the Nd:YAG laser procedure resulted in more pain during treatment and higher instances of scarring when compared to sclerotherapy. The study recorded significant differences in pain levels measured using the FLACC scale (Faces, Legs, Activity, Cry, Consolability), noting higher pain scores during and shortly after the laser treatment.
Despite the higher pain associated with the laser treatment, the overall treatment duration was shorter, making it appealing for procedural efficiency. Conversely, sclerotherapy appeared to be more patient-friendly, resulting in lower pain levels and less scarring.
At the six-month follow-up, there were no recurrences reported for either treatment method, emphasizing their effectiveness over time. The study highlights both treatments as viable options for PG management, with important distinctions based on pain tolerance and aesthetic concerns.
Given the similarities in efficacy but differences in patient experience, the study suggests sclerotherapy may be the preferred choice for children, prioritizing lower pain and reduced scarring risk.
Future research with larger patient populations and controlled methodology is recommended to continue exploring the nuances of each treatment.