Lasers, 595-nm pulsed dye and 1,064-nm neodymiumdoped yttrium aluminum garnet (Nd:YAG), have been used successfully for the treatment of infantile hemangiomas (IHs). Recently the use of a topical b-blocker, specifically timolol maleate, has been promising in the treatment of IHs. The objective of this study was to compare the effectiveness of topical timolol 5 mg/mL solution with that of combined sequential dual-wavelength laser in the treatment of IHs. Sixty children with IHs were divided randomly into two equal groups. Group 1 was treated with applications of timolol drops (5 mg/mL) twice daily. Group 2 was treated with sequential pulsed dye and Nd:Yag laser. Treatments were performed every month for a maximum of six sessions. Efficacy was evaluated clinically and by measuring the average hemoglobin level. A significant decrease in the average hemoglobin level was determined in both groups and a dramatic response was observed in superficial hemangiomas in the timolol group. The timolol group received treatment for an average of 4.0 AE 1.1 months and the laser group for 5.5 AE 0.9 months. The degree of improvement of mixed hemangiomas to laser treatment was greater than that of the timolol group. During 3 months of follow-up, no further improvement or relapse was reported in either group. Timolol solution is a safe and effective alternative to laser treatment in superficial hemangiomas. In mixed hemangiomas, the combined sequential 595-nm and 1,064-nm dual-wavelength laser provided better results than timolol solution because it penetrated deeply so that deep dermal blood vessels were reached.

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Nocturnal enuresis (NE) is intermittent involuntary voiding during sleep in a child aged 5 years or more. The study was conducted to compare the effect of using laser acupuncture and medication for the treatment of children with nocturnal enuresis (NE) and evaluation of urodynamic parameter after treatment. A randomized study included 45 children ranged from 5 to 15 years presenting with NE. They were randomized into three equal groups-group A, managed with desmopressin acetate; group B, managed with laser acupuncture; and group C, managed with a combination of laser acupuncture and desmopressin-all groups received behavioral therapy. The children were evaluated before and after 3 months of the study to record the efficacy of therapy, side effects and bladder capacity, and 3 months of follow-up after cessation of treatment by bladder diary. A statistically significant higher cure rate was reported in group B patients (73.3 %), while in groups A and C, improvement was reported in 20.0 and 13.3 %, respectively (p value = 0.002). Laser acupuncture is noninvasive, painless tool, with no side effects and lower recurrence rate which can be considered as an alternative therapy for patients with NE.

Burn scars are known for their tendency to worsen with hypertrophy and contracture, causing esthetic and functional problems. The objective is to analyze the effectiveness of low-level laser therapy on post-burn hypertrophic scar tissue in children. A randomized controlled study included 15 children, ranging from 2 to 10 years of age, presented with post-burn hypertrophic scars. They received He-Ne laser and topical treatment. Each scar was divided into two halves. One half was treated with laser therapy and topical treatment (study area), and the other half was treated with topical treatment only (control area). The children were evaluated before, and after 3 months of the study by Vancouver Scar Scale (VSS), ultrasonography, and laser Doppler perfusion imaging. Significant improvement was reported in the studied area, compared to the control area for patients with P values (P = 0.003) and (P = 0.005), for VSS and U/S scores, respectively. No differences were detected for blood perfusion of the scar between both areas (P = 0.73). In addition, no adverse effects were reported. Photobiomodulation (PBM) is an efficient and safe therapeutic modality for post-burn hypertrophic scars in children, with no side effects, and should be considered a part of combination therapy for better results.

The management of burn scars has become one of the major clinical challenges in the developing countries which involve enormous treatment cost; this needs new methods for better cost benefit relationship. The objective of the study is to analyze the effectiveness of low-level laser therapy on post-burn scar tissue in children. A randomized controlled study included 15 children, ranging from 2 to 10 years of age, presenting with burn scars. They received diode laser and topical treatment. Each scar was divided into two halves. One half was treated with laser therapy and topical treatment (study area), and the other half was treated with topical treatment only (control area). The children were evaluated before and after 3 months of the study by Vancouver Scar Scale (VSS), ultrasonography (U/S), and laser Doppler perfusion imaging. Significant improvement was reported in the studied area compared to the control area for patients with P values (P = 0.005) and (P = 0.0001) for VSS and U/S scores, respectively. No difference was detected for blood perfusion to the scar between both areas (P = 0.18). In addition, no adverse effect was reported. Photobiomodulation is an efficient and safe therapeutic modality for post-burn hypertrophic scars in children and should be considered a part of combination therapy for better results.