Investigation into optimal treatment intervals of facial port-wine stains using the pulsed dye laser

• Published in: Journal of the American Academy of Dermatology 2012-11, Vol.67 (5), p.985-990
• Main Authors: Anolik, Robert, MD, Newlove, Tracey, MD, Weiss, Elliot T., MD, Brightman, Lori, MD, Hale, Elizabeth K., MD, Karen, Julie K., MD, Bernstein, Leonard, MD, Geronemus, Roy G., MD
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; capillary vascular malformation; Dermatology; Face; Female; Hereditary diseases of the skin. Congenital diseases of the skin. Haemangioma of the skin, of mucosae and of soft tissue; Humans; Infant; Infant, Newborn; laser therapy; Lasers, Dye - therapeutic use; Male; Medical sciences; Port-Wine Stain - surgery; Retreatment - methods; Retrospective Studies; Treatment Outcome; vascular birthmarks
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2011.11.964

Background Port-wine stains (PWS) affect 0.3% to 0.5% of newborns and pulsed dye laser (PDL) remains the treatment of choice. Optimal treatment intervals have not been established. Objective We sought to validate the optimal treatment intervals for the management of facial PWS with PDL. Methods In all, 24 infants with facial PWS who received at least 5 treatments with the PDL at 2-, 3-, and 4-week intervals at a private laser and skin surgery center from 2009 to 2010 were identified by a retrospective chart review. Safety and efficacy were compared by blinded investigators. Results Side effects were equivalent in all interval groups and included only expected short-term erythema, edema, purpura, and mild postinflammatory hyperpigmentation. No patient developed hypopigmentation, scarring, or infection. All interval groups showed 50% to 100% clearance of their PWS after 5 treatments. Complete or near-complete clearance was seen in 6 of 8 (75%) and 7 of 8 (87.5%) patients in the 2- and 3-week interval groups, respectively, as compared with 3 of 8 (37.5%) patients in the 4-week interval group. Limitations This was a retrospective chart review from a single institution. Long-term side effects and recurrence rates were not assessed. Conclusion We conclude that PDL treatments at 2-, 3-, and 4-week intervals are effective for the management of facial PWS in infants with minimal short-term side effects. Shorter treatment intervals may allow for relatively more rapid and more effective treatment.