Complications of 585-nm pulsed dye laser therapy

Background Port-wine stains (PWS) are a congenital, progressive ectasia of the superficial cutaneous vascular plexus that occur in 0.3%-0.5% of children at birth. They should be considered a disease with physical and psychologic complications. Treatment with the flashlamp pulsed dye laser (FPDL) has proven to be effective. Because treatment results in selective vascular injury, the risk of complications is minimal. The purpose of this study was to determine the cutaneous side-effects and complications and their frequency in patients with PWS treated with the FPDL. Eighty-nine patients who had been treated with the FPDL for PWS were included in this study. Methods Patients were treated at 8-month intervals using slightly overlapping pulses with fluences of 6.0-9.0 J/cm(2). Treating physicians were responsible for evaluating the patients. All patients were reviewed and side-effects and complications were recorded. Results Pigmentary changes were the most frequently observed complications. Hyper and hypopigmentation appeared in 16.8% and 2.4% of patients, respectively. Cutaneous depressions occurred in 2.2% of patients. One patient developed a hypertrophic scar, and another patient presented with transient cutaneous pustulosis. All these changes usually resolved spontaneously and completely in a few months. Conclusions Most of the side-effects and complications produced by the FPDL are usually transitory, and it is essentially a very secure technique.