Outcomes of 532 nm frequency-doubled Nd:YAG laser use in the treatment of port-wine stains.

BACKGROUND: Port-wine stains (PWSs) are congenital dermal malformations involving venules, capillaries, and, probably, perivascular nerves. The primary morbidities of PWS are psychological disturbances that adversely affect the development of personality. Lasers have been the treatment of choice for PWS. However, only one type of laser is not a panacea for all PWS malformations. For the treatment of PWSs, carbon dioxide, argon, krypton, copper bromide, frequency-doubled neodymium:yttrium-aluminum-garnet (Nd:YAG), flashlamp pumped pulsed dye laser, and also intense pulsed light sources can be used.

OBJECTIVE: To determine the efficacy and the frequency of side effects of the frequency-doubled Nd:YAG laser for the treatment of PWSs.

PATIENTS AND METHODS: In this study, 532 nm frequency-doubled Nd:YAG laser with a 2 to 6 mm spot size, 15- to 50-millisecond pulse width, and a 9.5 to 20 J/cm2 fluence was applied for 89 patients (62 female, 27 male; age range 3-49 years) with PWSs on the face and/or neck for 1 to 12 sessions, with 2-month treatment-free intervals. Improvement rates were considered a failure (< 25%), mild (25-49%), moderate (50-74%), good (75-94%), and excellent (> 95%).

RESULTS: Excellent (n = 12; 13%), good (n = 34; 38%), moderate (n = 39; 44%), and mild (n = 4; 5%) improvement of lesions was obtained after an average of 5.6, 5.5, 4.4, and 3.8 therapy sessions, respectively. No treatment failure was observed for any patient. As adverse effects, transient hyperpigmentation (n = 2; 2.25%), hypopigmentation (n = 1; 1.12%), and hypotrophic scarring (n = 1; 1.12%) were noted.

CONCLUSIONS: The results obtained asserted that the frequency-doubled Nd:YAG laser is a quick, safe, and effective treatment modality for PWS malformations and can be appreciated as a useful alternative therapy that can raise the rates of success in cases with PWSs refractory to other laser therapies.