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  • Title: Treatment of port-wine stain birthmarks using the 1.5-msec pulsed dye laser at high fluences in conjunction with cryogen spray cooling.
    Author: Kelly KM, Nanda VS, Nelson JS.
    Journal: Dermatol Surg; 2002 Apr; 28(4):309-13. PubMed ID: 11966787.
    Abstract:
    BACKGROUND: The majority of port-wine stain (PWS) patients treated with the pulsed dye laser (PDL) do not achieve complete blanching. Safe administration of higher fluences has been proposed as a means of improving treatment efficacy. OBJECTIVE: To determine the safety and efficacy of PWS treatment with the 1.5-msec PDL at high fluences in conjunction with cryogen spray cooling. METHODS: Twenty PWS patients were treated with the PDL in combination with cryogen spray cooling utilizing a 7 or 10 mm spot size and fluences ranging from 6 to 15 J/cm2. Before and after treatment photographs were compared on a blinded basis. RESULTS: No scarring or skin textural changes occurred. Blanching scores were as follows: 20% of patients achieved 75% or greater blanching after an average of 3.3 treatments, 30% achieved 50-74% blanching, 20% achieved 25-49% blanching, and 30% achieved less than 25% blanching. CONCLUSION: In conjunction with cryogen spray cooling, the PDL can be safely used at high fluences. At this time it is not clear that the use of higher fluences improves treatment efficacy; however, as other aspects of PWS laser treatment are optimized, safe administration of higher fluences is likely to be advantageous.
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