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Great Ormond Street Hospital for Children NHS Trust UCL Institute of Child Health
 

Children and families

Carbon dioxide laser surgery for skin lesions

This leaflet explains how carbon dioxide (CO2) lasers can be used to treat skin lesions and what to expect when your child comes to Great Ormond Street Hospital for treatment.

Contents

What is a carbon dioxide (CO2) laser?

Lasers are used in various ways but are most commonly used at Great Ormond Street Hospital to treat birthmarks and other skin lesions. Carbon dioxide (CO2) lasers work by sending out a concentrated beam of light that affects the skin.

CO2 lasers can be used in a range of ways. For instance, if the beam of light is ‘focused’ the laser can be used for cutting the skin or removing tissue. ‘Defocused’ or ‘ultra-pulsed’ CO2 lasers can resurface the skin by smoothing out lines, lesions and wrinkles.

Why does my child need laser surgery?

When a birthmark or skin lesion is causing problems, either physical or psychological, it may be best to remove it. CO2 laser surgery is often suggested as an alternative to traditional surgery as it can remove the top layers of the lesion, often with less scarring.
Depending on your child’s age and the type and location of the lesion, he or she may have laser surgery under local anaesthetic (where just the area treated is numb) or general anaesthetic. The surgeon will discuss this with you before the procedure is scheduled.

What happens before laser surgery?

You will receive information on how to prepare your child for the operation in his or her admission letter. The surgeon will need to see you to explain the laser surgery in more detail, discuss any worries you may have and ask you to give permission for the surgery by signing a consent form. If your child has any medical problems, such as allergies, please tell the surgeon. He or she may ask for photographs to be taken of your child’s skin lesion to record it before treatment, so that the improvement afterwards can be measured.

What does laser surgery involve?

Once your child is in theatre, the surgeon will prepare the area to be treated by cleaning it thoroughly. He or she will then sweep the laser over the area to remove the top layer of skin. The lesion is treated layer by layer, wiping away each layer of skin after each sweep. At the end of treatment, the area will look like a graze, which will heal and hopefully leave few scars.

Are there any risks involved?

The risks of laser surgery are the same as with traditional surgery. The area of skin treated will feel sore afterwards and will need careful looking after for the first few weeks. A regular dose of paracetamol according to the instructions on the bottle is usually enough to take away the pain. Putting an ice pack wrapped in a clean tea towel over the treated area can also help to ease the pain. As with any wound, there is a small chance that it could get infected, in which case antibiotics will be needed. The treatment can change the colour of the skin making it darker or lighter. Sometimes, pre-treatment creams are used to reduce this risk.

What happens afterwards?

Once your child has recovered from the general anaesthetic and is comfortable, you will be able to go home. Depending on how the lesion has been treated, the area may be covered with a dressing to protect it for the first few days. The ward nurses will advise you about the care needed. Sometimes we ask for help from your GP or district nurse.

When you get home

Your child’s skin will need special care for the first few weeks after laser surgery. For instance, avoid soap, bubble bath and shower gels that dry the skin. The treated skin will be dry and may crack or a crust may form over it. To prevent this, the nurses will advise applying an emollient cream such as E45® or Nivea® to the area. Never pick the crust off – allow it to fall off in its own time. The treated area could be damaged if it is knocked, so your child should avoid PE and rough play for at least two weeks after treatment. Swimming should also be avoided for at least two weeks because the chlorine in the pool water may dry the treated area, and this is a risk of infection. For up to a year after treatment, the area must be covered in sunscreen whenever your child goes outside as sun can darken the treated area.

You should call the ward if:

  • Your child is in a lot of pain and pain relief does not seem to help

  • Your child has a temperature of 38°C and paracetamol does not bring it down

  • The treated area of skin oozes or starts to smell

If you have any questions,
please telephone Tiger Ward on 020 7829 8823

Ref: F050229 © GOSH Trust July 2005
Compiled by Tiger Ward in collaboration with the Child and Family Information Group.
This information does not constitute health or medical advice and will not necessarily reflect treatment at other hospitals. If you have any questions, please ask your doctor. No liability can be taken as a result of using this information.

This page was last updated on 7 August, 2008