The use of topical anesthesia in removal of port-wine stains in children.

The control of pain associated with laser treatment of port-wine stains in children has been problematic. Using EMLA, a topical anesthetic, children can be treated with a significant reduction in laser-induced pain. In this prospective, double-blind, placebo-controlled, randomized trial of EMLA, 73 children (35 boys and 38 girls) ranging in age from 5 to 16 years with port-wine stains were treated. EMLA reduced mean pain scores 66% when compared with control subjects (p < 0.0001 for all three assessments of pain). Concordance between evaluators' and patients' assessment of pain scores correlated strongly (p < 0.001). Treatment with EMLA abolished pain in 40% of patients and the percentage of pain-free treatments increased from 10% to 52% (p < 0.001). EMLA is clearly effective in reducing or eliminating pain associated with laser treatment of port-wine stains in children.