Pigmentary changes after pulsed dye laser treatment in 125 northern European patients with port wine stains

Abstract

We investigated the occurrence of pigmentary changes after flash lamp pumped dye laser treatment in 125 Norwegian patients. Post-treatment hyperpigmentation occurred with equal frequency during summer and winter (23%), and the facial regions did not exhibit higher occurrence than lesions located elsewhere. The patients that achieved hyperpigmented skin were not exposed to any higher fluence than those without this complication. On the contrary, we found that during the summer period from April to September the patients with post-treatment hyperpigmentation had been exposed to a significantly lower dose than those without pigmentary changes. These results indicate that the epidermal melanin content is not the only criterion for obtaining post-treatment hyperpigmentation. There might also be a constitutional disposition. In predisposed individuals the threshold dose for hyperpigmentation might be reduced in summer when the skin is more pigmented.

Intense pulsed light source for the treatment of dye laser resistant port‐wine stains

“…22,30,31 For lesions in the central part of the face especially, abnormal vessels are generally located deeper in the skin than in other anatomical sites. 7,27,32 These vessels require treatments with longer wavelengths with deeper penetration and higher energy levels to compensate for the increased scattering and lower absorption. The relatively short wavelength of the PDL (575-590 nm) might be a reason for the lack of clear-ance seen in this area.…”

“…The final outcome has been found to be dependent on many factors, such as: (1) the applied light energy; (2) the pulse duration; (3) the wavelength or wavelength spectrum; (4) concomitant cooling of the skin surface 24,25 ; (5) anatomical location and size of the abnormal vessels; and (6) the degree of epidermal melanin concentration. [26][27][28] The lack of clearance of a subset of PDL-treated PWS prompts for investigations into new and improved treatment modalities. [7][8][9][10][11] In the present study, the IPL technology was used to treat PDL-resistant PWS with a response rate of 46.7% and with an average clearance for the responders of 83.9% (SD: 9.5%).…”

Hypertrophic Scarring and Keloids: Pathomechanisms and Current and Emerging Treatment Strategies

“…Adverse effects include transient hyper-or hypopigmentation and blistering (125,128). Hyperpigmentation has been reported with a frequency of 1-24% (129,130). The most common adverse side effect of 585-nm PDL treatment is postoperative purpura, which can persist for 7-10 days.…”

The Use of Variable Pulse Width Frequency Doubled Nd:YAG 532 nm Laser in the Treatment of Port-Wine Stain in Chinese Patients

“…Their findings indicate that the lack of selectivity of this laser when applied to brown skin was due to the high concentration of epidermal melanin. 7,8 Epidermal cooling has been proposed to reduce the side effects and improve the clinical efficacy of vascular lasers. Other European series have found a much lower degree of pigmentary change when patients with lighter skin types are treated.…”