Sclerotherapy with bleomycin can cause cosmetic complications, including flagellate dermatitis and hyperpigmentation, induced or exacerbated by microtrauma to the skin. We report a case of a 9-year-old pediatric patient with congenital vascular malformations in which a cohesive bandage (eg, 3M Coban) was utilized to prevent bleomycin-induced hyperpigmentation. Postoperatively and on follow-up, there were no signs of hyperpigmentation or dermatitis in our patient. This report highlights using skin protective measures during bleomycin sclerotherapy for improved postoperative outcomes. If a patient is undergoing bleomycin sclerotherapy, consider removing adhesive where possible and using cohesive bandage to secure lines, airway instruments, and monitoring equipment.

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