Saturday, December 5, 2020

New options for removal of vascular birthmarks

Dr. Wasserman and his team Sarah Szempruch, Maribel Diaz and Chris Diaz. -PHOTO BY VAL SIMON/COASTAL BREEZE NEWS

Dr. Wasserman and his team Sarah Szempruch, Maribel Diaz and Chris Diaz. -PHOTO BY VAL SIMON/COASTAL BREEZE NEWS

Jane A. Marlowe

Dr. Daniel I. Wasserman, MD FAAD, is a Board Certified Dermatologist with Riverchase Dermatology and Cosmetic Surgery with offices on Marco Island and Naples, Florida. He is a fellowship-trained laser and skin cancer surgeon. Dr. Wasserman, following his residency, did a one year extra fellowship in lasers and light medicine at Harvard Medical School with Dr. Richard Rox Anderson, who invented a laser for removal of vascular malformations. It is called Pulsed Dye Laser and the process is selective photothermolysis.

Dr. Wasserman considers Dr. Anderson a giant in the field of dermatology and laser light surgery. Dr. Anderson originated the theory of selective photothermolysis while he was a medical student. He has invented numerous devices which are in use in the field of dermatology. When Dr. Wasserman completed his training at Harvard, he did a year of fellowship with Dr. Gary Monheit in the Mohs surgical skin cancer procedure in Birmingham, Alabama. He considers himself to be very lucky to have benefitted from outstanding mentors across the spectrum of dermatology.

The laser allows surgeons to selectively heat red cells without damaging the other tissue. For a red object like vascular malformations, surgeons use the opposite color, yellow, just as we learned in elementary art classes. The Pulsed Dye Laser has transformed our ability to treat the skin. The laser can treat hemangiomas, port wine stains, venous malformations and other types of vascular birthmarks.  The laser allows treatment of younger patients even young babies. The best time to treat a PWS is when a child is an infant or at least still a child. The laser can only penetrate 2mm. into the skin which is very thin in an infant and thus presents the most favorable time for intervention with the hope of complete and permanent removal.

Port wine stains will not disappear over time. The area is receiving increased oxygen through the dense vascular birthmark and the area can grow out of proportion to the rest of the body part where the birthmark is located. For example, a PWS on the arm causes bone and skin structure to be heavier and the arm will be disproportionate on the birthmark side. In addition, a PWS can grow out and cause a bump or tumor- like anomaly which is even more disfiguring and difficult to avoid during routine personal care.

There can be serious complications from PWS, one in particular if the birthmark is on the face.  Sturge-Webber syndrome is manifested by seizures, cognitive impairment, glaucoma, facial vascular malformations. Not everyone who is affected by Sturge-Webber will demonstrate the same or all the symptoms but the port wine stain follows a nerve and, on the face, can include vision problems. Care must be taken when a port wine stain is present and a neurologist should be consulted to insure there are no neurological issues which need to be addressed.

Hemangiomas are the only birthmarks that often disappear over time. The teaching is that 90% will be gone by age 9 but there is a danger of ulceration and scarring during a baby’s typical rapid growth phase at the 6 months stage of development. In addition to good medical practice, there is a positive emotional component for a child to receive early treatment. “Nine years old may be too old for a kid to walk around with a birthmark, waiting for it to go away.” commented Dr. Wasserman.

Dr. Wasserman is particularly interested in treating infants and children with birthmarks in order to prevent risks which are inherent in the condition, as well as give them the best opportunity for a childhood free of the kind of social isolation which often results from a hemangioma or port wine stain in a noticeable area of the body. He paraphrased the late Steve Jobs of Apple during his commencement address at Stanford University a few years ago.

“If you do what you love and you do well, you can make a difference in the life of the child you treat.” “We can treat birthmarks as early as possible, the earlier the better. Treatment doesn’t come without risks, but the lesions can be treated. It is not comfortable, there will be bruising and swelling but those symptoms will disappear. Just coming to talk to the doctor doesn’t hurt. You will come out of the visit more informed…don’t wait and it is never too late.”

The light laser will be available in early 2012 at the downtown office of Riverchase Dermatology. It can be used for cosmetic and restorative procedures as well as for the removal of vascular birthmarks.  Dr. Wasserman encourages families who are interested in Pulsed Dye Laser technology to contact him at Riverchase Dermatology on Marco Island or Downtown Naples. He looks forward to consulting and serving the needs of the entire Marco Island and surrounding communities. Riverchase Dermatology offices are located in the SunTrust building on North Collier Boulevard, Marco Island and in Naples on Immokalee Road and their new downtown office on Ninth Street North, two blocks from 5th Ave.

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