CLINICAL EFFICACY OF THE PULSED DYE-LASER IN THE TREATMENT OF VASCULAR-LESIONS

BACKGROUND. Increasing the selectivity of laser-induced damage is an ongoing goal for the laser treatment of cutaneous lesions. The flashlamp-pumped pulsed dye laser has significantly participated and advanced this pursuit. This is especially true in its use for the treatment of cutaneous vascular lesions. OBJECTIVE. A review of the development and current use of this laser for the treatment of cutaneous vascular lesions will be presented. METHODS. The laser has been designed to limit laser energy absorption and damage to hemoglobin and the blood vessel. This has been done by setting the wavelength at 577 to 585 nm and the pulse duration at 360 to 450 museconds. RESULTS. The therapeutic results have been beneficial for almost all types of superficial small vessel vascular lesions regardless of lesional anatomic site or patient age. These lesions include port-wine stains, telangiectasia, capillary hemangioma, and other angiomata and vascular ectasia. Deeper cutaneous vascular processes and lower extremity telangiectases have proven to be less responsive to therapy. The increased vascular selectivity has allowed for a dramatic decrease in adverse effects when compared to previously used laser systems. CONCLUSION. Based on many thousands of treatment sessions and follow-up evaluation, the pulsed dye laser appears to have the greatest margin of safety in the treatment of cutaneous vascular lesions, especially for the pediatric populations.