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Vascular Lasers and Lights

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Evidence-Based Procedural Dermatology

Abstract

Vascular lasers and lights have evolved considerably over the last 30 years since Anderson and Parrish published their landmark paper on selective photothermolysis [1]. Previously, continuous wave (argon and copper vapor) lasers were used to treat vascular lesions, but resulted in significant side effects such as scarring or pigmentary changes. With the understanding that laser energy can be modified for preferential absorption by the intended target, or chromophore, heat could be delivered in a more controlled manner that did not result in destruction of surrounding tissues. The laser wavelength could be matched to the absorption spectra of the targeted chromophore. By the 1990s, the pulsed dye laser (PDL) was established as the gold standard for vascular lesions [2]. Its wavelengths of 577–595 nm match the spectrum for oxyhemoglobin, which is in blood vessels. Figure 12.1 demonstrates the absorption spectra of hemoglobin. The 532 nm wavelength has also been explored for its strong absorption by hemoglobin.

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References

  1. Anderson RR, Parrish JA. Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science. 1983;220:524–7.

    Article  PubMed  CAS  Google Scholar 

  2. Alster TS, Wilson F. Treatment of port-wine stains with the flash lamp-pumped pulsed dye laser: extended clinical experience in children and adults. Ann Plast Surg. 1994;32:478–84.

    Article  PubMed  CAS  Google Scholar 

  3. Adamic M, Troilius A, Adatto M, Drosner M, Dahmane R. Vascular lasers and IPLs: guidelines for care from the European Society for Laser Dermatology (ESLD). J Cosmet Laser Ther. 2007;9:113–24.

    Article  PubMed  Google Scholar 

  4. Grantzow R, Schmittenbecher P, Cremer H, Hoger P, Rossler J, Hamm H, et al. Hemangiomas in infancy and childhood. S 2k guideline of the German Society of Dermatology with the working group Pediatric Dermatology together with the German Society for Pediatric Surgery and the German Society for Pediatric Medicine. J Dtsch Dermatol Ges. 2008;6:324–9.

    Article  PubMed  Google Scholar 

  5. Frieden IJ, Eichenfield LF, Esterly NB, Geronemus R, Mallory SB. Guidelines of care for hemangiomas of infancy. American Academy of Dermatology Guidelines/Outcomes Committee. J Am Acad Dermatol. 1997;37:631–7.

    Article  PubMed  CAS  Google Scholar 

  6. Hohenleutner S, Badur-Ganter E, Landthaler M, Hohenleutner U. Long-term results in the treatment of childhood hemangioma with the flashlamp-pumped pulsed dye laser: an evaluation of 617 cases. Lasers Surg Med. 2001;28:273–7.

    Article  PubMed  CAS  Google Scholar 

  7. Poetke M, Philipp C, Berlien HP. Flashlamp-pumped pulsed dye laser for hemangiomas in infancy: treatment of superficial vs mixed hemangiomas. Arch Dermatol. 2000;136:628–32.

    Article  PubMed  CAS  Google Scholar 

  8. Ho WS, Chan HH, Ying SY, Chan PC. Laser treatment of congenital facial port-wine stains: long-term efficacy and complication in Chinese patients. Lasers Surg Med. 2002;30:44–7.

    Article  PubMed  Google Scholar 

  9. Huikeshoven M, Koster P, de Borgie C, Beek JF, Gemert M, van der Horst C. Redarkening of port-wine stains 10 years after pulsed-dye laser treatment. N Engl J Med. 2007;356:1235–40.

    Article  PubMed  CAS  Google Scholar 

  10. Soueid A, Waters R. Re-emergence of port wine stains following treatment with flashlamp-pumped dye laser 585 nm. Ann Plast Surg. 2006;57:260–3.

    Article  PubMed  CAS  Google Scholar 

  11. Sivarajan V, Al Aissami M, Maclaren W, Mackay IR. Recurrence of spider naevi following treatment with 585 nm pulsed dye laser. J Plast Reconstr Aesthet Surg. 2007;60:668–71.

    Article  PubMed  CAS  Google Scholar 

  12. Geronemus RG, Quintana AT, Lou WW, Kauvar A. High-fluence modified pulsed dye laser photocoagulation with dynamic cooling of port-wine stains in infancy. Arch Dermatol. 2000;136:942–4.

    Article  PubMed  CAS  Google Scholar 

  13. Chiu CH, Chan HH, Ho WS, Yeung CK, Nelson JS. Prospective study of pulsed dye laser in conjunction with cryogen spray cooling for treatment of port wine stains in Chinese patients. Dermatol Surg. 2003;29:909–15.

    Article  PubMed  Google Scholar 

  14. Chapas AM, Eickhorst K, Geronemus RG. Efficacy of early treatment of facial port wine stains in newborns: a review of 49 cases. Lasers Surg Med. 2007;39:563–8.

    Article  PubMed  Google Scholar 

  15. Rizzo C, Brightman L, Chapas AM, Hale EK, Cantatore-Francis JL, Bernstein LJ, et al. Outcomes of childhood hemangiomas treated with the pulsed-dye laser with dynamic cooling: a retrospective chart analysis. Dermatol Surg. 2009;35:1947–54.

    Article  PubMed  CAS  Google Scholar 

  16. Scherer K, Lorenz S, Wimmershoff M, Landthaler M, Hohenleutner U. Both the flashlamp-pumped dye laser and the long-pulsed tunable dye laser can improve results in port-wine stain therapy. Br J Dermatol. 2001;145:79–84.

    Article  PubMed  CAS  Google Scholar 

  17. Woo SH, Ahn HH, Kim SN, Kye YC. Treatment of vascular skin lesions with the variable-pulse 595 nm pulsed dye laser. Dermatol Surg. 2006;32:41–8.

    Article  PubMed  CAS  Google Scholar 

  18. Asahina A, Watanabe T, Kishi A, Hattori N, Shirai A, Kagami S, et al. Evaluation of the treatment of port-wine stains with the 595 nm long pulsed dye laser: a large prospective study in adult Japanese patients. J Am Acad Dermatol. 2006;54:487–93.

    Article  PubMed  Google Scholar 

  19. Latkowski IT, Wysocki MS, Siewiera IP. Own clinical experience in treatment of port-wine stain with KTP 532 nm laser [article in Polish]. Wiad Lek. 2005;58: 391–6.

    PubMed  Google Scholar 

  20. Chowdhury MM, Harris S, Lanigan SW. Potassium titanyl phosphate laser treatment of resistant port-wine stains. Br J Dermatol. 2001;144:814–7.

    Article  PubMed  CAS  Google Scholar 

  21. Pence B, Aybey B, Ergenekon G. Outcomes of 532 nm frequency-doubled Nd:YAG laser use in the treatment of port-wine stains. Dermatol Surg. 2005;31:509–17.

    Article  PubMed  Google Scholar 

  22. Raulin C, Greve B. Retrospective clinical comparison of hemangioma treatment by flashlamp-pumped (585 nm) and frequency-doubled Nd:YAG (532 nm) lasers. Lasers Surg Med. 2001;28:40–3.

    Article  PubMed  CAS  Google Scholar 

  23. Chan HH, Chan E, Kono T, Ying SY, Wai-Sun H. The use of variable pulse width frequency doubled Nd:YAG 532 nm laser in the treatment of port-wine stain in Chinese patients. Dermatol Surg. 2000;26:657–61.

    Article  PubMed  CAS  Google Scholar 

  24. Bernstein EF. High-energy 595 nm pulsed dye laser improves refractory port-wine stains. Dermatol Surg. 2006;32:26–33.

    Article  PubMed  CAS  Google Scholar 

  25. Alam M, Dover JS, Arndt KA. Treatment of facial telangiectasia with variable-pulse high-fluence pulsed-dye laser: comparison of efficacy with fluences immediately above and below the purpura threshold. Dermatol Surg. 2003;29:681–4.

    Article  PubMed  Google Scholar 

  26. Rohrer TE, Chatrath V, Iyengar V. Does pulse stacking improve the results of treatment with variable-pulse pulsed-dye lasers? Dermatol Surg. 2004;30 (2 Pt 1):163–7.

    Article  PubMed  Google Scholar 

  27. Bernstein EF, Brown DB. Efficacy of the 1.5 millisecond pulse-duration, 585 nm, pulsed-dye laser for treating port-wine stains. Lasers Surg Med. 2005;36: 341–6.

    Article  PubMed  Google Scholar 

  28. Yung A, Sheehan-Dare R. A comparative study of a 595-nm with a 585-nm pulsed dye laser in refractory port wine stains. Br J Dermatol. 2005;153:601–6.

    Article  PubMed  CAS  Google Scholar 

  29. Greve B, Raulin C. Prospective study of port wine stain treatment with dye laser: comparison of two wavelengths (585 nm vs. 595 nm) and two pulse durations (0.5 milliseconds vs. 20 milliseconds). Lasers Surg Med. 2004;34:168–73.

    Article  PubMed  Google Scholar 

  30. Schroeter CA, Haaf-von Below S, Neumann HA. Effective treatment of rosacea using intense pulsed light systems. Dermatol Surg. 2005;31:1285–9.

    Article  PubMed  CAS  Google Scholar 

  31. Ozdemir M, Engin B, Mevlitoglu I. Treatment of facial port-wine stains with intense pulsed light: a prospective study. J Cosmet Dermatol. 2008;7:127–31.

    Article  PubMed  Google Scholar 

  32. Reynolds N, Exley J, Hills S, Falder S, Duff C, Kenealy J. The role of the lumina intense pulsed light system in the treatment of port wine stains – a case controlled study. Br J Plast Surg. 2005;58:968–80.

    Article  PubMed  CAS  Google Scholar 

  33. Ho WS, Ying SY, Chan PC, Chan HH. Treatment of port wine stains with intense pulsed light: a prospective study. Dermatol Surg. 2004;30:887–90.

    Article  PubMed  Google Scholar 

  34. Bjerring P, Christiansen K, Troilius A. Intense pulsed light source for the treatment of dye laser resistant port-wine stains. J Cosmet Laser Ther. 2003;5:7–13.

    PubMed  CAS  Google Scholar 

  35. Izikson L, Nelson JS, Anderson RR. Treatment of hypertrophic and resistant port wine stains with a 755 nm laser: a case series of 20 patients. Lasers Surg Med. 2009;41:427–32.

    Article  PubMed  Google Scholar 

  36. Yang MU, Yaroslavsky AN, Farinelli WA, Flotte TJ, Rius-Diaz F, Tsao SS, et al. Long-pulsed neodymium:yttrium-aluminum-garnet laser treatment for port-wine stains. J Am Acad Dermatol. 2005;52(3 Pt 1):480–90.

    Article  PubMed  Google Scholar 

  37. Alster TS, Tanzi EL. Combined 595-nm and 1,064-nm laser irradiation of recalcitrant and hypertrophic port-wine stains in children and adults. Dermatol Surg. 2009;35:914–8.

    Article  PubMed  CAS  Google Scholar 

  38. Burns AJ, Navarro JA. Role of laser therapy in pediatric patients. Plast Reconstr Surg. 2009;124(Suppl): 82e–92.

    Article  PubMed  CAS  Google Scholar 

  39. Witman PM, Wagner AM, Scherer K, Waner M, Frieden IJ. Complications following pulsed dye laser treatment of superficial hemangiomas. Lasers Surg Med. 2006;38:116–23.

    Article  PubMed  Google Scholar 

  40. McGill DJ, MacLaren W, Mackay IR. A direct comparison of pulsed dye, alexandrite, KTP, and Nd:YAG lasers and IPL in patients with previously treated capillary malformations. Lasers Surg Med. 2008;40:390–8.

    Article  PubMed  Google Scholar 

  41. Gu Y, Huang NY, Liang J, Pan YM, Liu FG. Clinical study of 1949 cases of port wine stains treated with vascular photodynamic therapy (Gu’s PDT) [article in French]. Ann Dermatol Venereol. 2007;134(3 Pt 1): 241–4.

    Article  PubMed  CAS  Google Scholar 

  42. Lu YG, Wu JJ, Yang YD, He Y. Photodynamic therapy of port-wine stains. J Dermatolog Treat. 2010;21:240–4.

    Article  PubMed  CAS  Google Scholar 

  43. Chang CJ, Hsiao YC, Mihm Jr MC, Nelson JS. Pilot study examining the combined use of pulsed dye laser and topical imiquimod versus laser alone for treatment of port wine stain birthmarks. Lasers Surg Med. 2008;40:605–10.

    Article  PubMed  Google Scholar 

  44. Jia W, Sun V, Tran N, Choi B, Liu SW, Mihm Jr MC, et al. Long-term blood vessel removal with combined laser and topical rapamycin antiangiogenic therapy: implication for effective port wine stain treatment. Lasers Surg Med. 2010;42:105–12.

    Article  PubMed  Google Scholar 

  45. Batta K, Goodyear HM, Moss C, Williams HC, Hiller L, Waters R. Randomized controlled study of early pulsed dye laser treatment of uncomplicated childhood hemangiomas: results of a 1-year analysis. Lancet. 2002;360:521–7.

    Article  PubMed  Google Scholar 

  46. Cameron H, Ibbotson SH, Ferguson J, Dawe RS, Moseley H. A randomized, blinded, controlled study of the clinical relevance of matching pulse duration to thermal relaxation time when treating facial telangiectasia. Lasers Med Sci. 2005;20:117–21.

    Article  PubMed  Google Scholar 

  47. Kono T, Sakurai H, Groff WF, Chan HH, Takeuchi M, Yamaki T, et al. Comparison study of a traditional pulsed dye laser versus a long-pulsed dye laser in the treatment of early childhood hemangiomas. Lasers Surg Med. 2006;38:112–5.

    Article  PubMed  Google Scholar 

  48. Hammes S, Roos S, Raulin C, Ockenfels HM, Greve B. Does dye laser treatment with higher fluences in combination with cold air cooling improve the results of port-wine stains? J Eur Acad Dermatol Venereol. 2007;21:1129–33.

    Article  Google Scholar 

  49. Tomson N, Lim SP, Abdullah A, Lanigan SW. The treatment of port-wine stains with the pulsed-dye laser at 2-week and 6-week intervals: a comparative study. Br J Dermatol. 2006;154:676–9.

    Article  PubMed  CAS  Google Scholar 

  50. Evans AV, Robson A, Barlow RJ, Kurwa HA. Treatment of port wine stains with photodynamic therapy, using pulsed dye laser as a light source, compared with pulsed dye laser alone: a pilot study. Lasers Surg Med. 2005;36:266–9.

    Article  PubMed  Google Scholar 

  51. Faurschou A, Togsverd-Bo K, Zachariae C, Haedersdal M. Pulsed dye laser vs. intense pulsed light for port-wine stains: a randomized side-by-side trial with blinded response evaluation. Br J Dermatol. 2009;160:359–64.

    Article  PubMed  CAS  Google Scholar 

  52. Jorgensen GF, Hedelund L, Haedersdal M. Long-pulsed dye laser versus intense pulsed light for photodamaged skin: a randomized split-face trial with blinded response evaluation. Lasers Surg Med. 2008;40:293–9.

    Article  PubMed  Google Scholar 

  53. Nymann P, Hedelund L, Haedersdal M. Intense pulsed light vs. long-pulsed dye laser treatment of telangiectasia after radiotherapy for breast cancer: a randomized split-lesion trial of two different treatments. Br J Dermatol. 2009;160:1237–41.

    Article  PubMed  CAS  Google Scholar 

  54. Neuhaus IM, Zane LT, Tope WD. Comparative efficacy of nonpurpuragenic pulsed dye laser and intense pulsed light for erythematotelangiectatic rosacea. Dermatol Surg. 2009;35:920–8.

    Article  PubMed  CAS  Google Scholar 

  55. Uebelhoer NS, Bogle MA, Stewart B, Arndt KA, Dover JS. A split-face comparison study of pulsed 532-nm KTP laser and 595-nm pulsed dye laser in the treatment of facial telangiectasias and diffuse telangiectatic facial erythema. Dermatol Surg. 2007;33:441–8.

    Article  PubMed  CAS  Google Scholar 

  56. Collyer J, Boone SL, White LE, Rademaker A, West DP, Anderson K, et al. Comparison of treatment of cherry angiomata with pulsed-dye laser, potassium titanyl phosphate laser, and electrodessication: a randomized controlled trial. Arch Dermatol. 2010;146:33–7.

    Article  PubMed  Google Scholar 

  57. Karsai S, Roos S, Raulin C. Treatment of facial telangiectasia using a dual-wavelength laser system (595 and 1,064 nm): a randomized controlled trial with blinded response evaluation. Dermatol Surg. 2008;34:702–8.

    Article  PubMed  CAS  Google Scholar 

  58. Spendel S, Prandl EC, Schintler MV, Siegl A, Wittgruber G, Hellborn B, et al. Treatment of spider leg veins with the KTP (532 nm) laser – a prospective study. Lasers Surg Med. 2002;31:194–201.

    Article  PubMed  Google Scholar 

  59. McMeekin TO. Treatment of spider veins of the leg using a long-pulsed Nd:YAG laser (Versapulse) at 532 nm. J Cutan Laser Ther. 1999;1:179–80.

    PubMed  CAS  Google Scholar 

  60. Brunnberg S, Lorenz S, Landthaler M, Hohenleutner U. Evaluation of the long pulsed high fluence alexandrite laser therapy of leg telangiectasia. Lasers Surg Med. 2002;31:359–62.

    Article  PubMed  Google Scholar 

  61. Ross EV, Meehan KJ, Gilbert S, Domankevitz Y. Optimal pulse durations for the treatment of leg telangiectasias with an alexandrite laser. Lasers Surg Med. 2009;41:104–9.

    Article  PubMed  CAS  Google Scholar 

  62. Eremia S, Li C, Umar SH. A side-by-side comparative study of 1064 nm Nd:YAG, 810 nm diode and 755 nm alexandrite lasers for treatment of 0.3–3 mm leg veins. Dermatol Surg. 2002;28:224–30.

    Article  PubMed  Google Scholar 

  63. Parlette EC, Groff WF, Kinshella MJ, Domankevitz Y, O’Neill J, Ross EV. Optimal pulse durations for the treatment of leg telangiectasias with a neodymium YAG laser. Lasers Surg Med. 2006;38:98–105.

    Article  PubMed  Google Scholar 

  64. Levy JL, Elbahr C, Jouve E, Mordon S. Comparison and sequential study of long pulsed Nd:YAG 1,064 nm laser and sclerotherapy in leg telangiectasias treatment. Lasers Surg Med. 2004;34:273–6.

    Article  PubMed  Google Scholar 

  65. Lupton JR, Alster TS, Romero P. Clinical comparison of sclerotherapy versus long-pulsed Nd:YAG laser treatment for lower extremity telangiectasias. Dermatol Surg. 2002;28:694–7.

    Article  PubMed  Google Scholar 

  66. Leach BC, Goldman MP. Comparative trial between sodium tetradecyl sulfate and glycerin in the treatment of telangiectatic leg veins. Dermatol Surg. 2003;29:612–4.

    Article  PubMed  Google Scholar 

  67. Rao J, Wildemore JK, Goldman MP. Double-blind prospective comparative trial between foamed and liquid polidocanol and sodium tetradecyl sulfate in the treatment of varicose and telangiectatic leg veins. Dermatol Surg. 2005;31:631–5.

    Article  PubMed  CAS  Google Scholar 

  68. McCoy S, Evans A, Spurrier N. Sclerotherapy for leg telangiectasia – a blinded comparative trial of polidocanol and hypertonic saline. Dermatol Surg. 1999;25: 381–5.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Dermatology, Tulane University School of Medicine, Old Metairie Dermatology, 701 Metairie Road, Suite 2A-205, Metairie, LA, USA

    Nicole E. Rogers

  2. Department of Dermatology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY, USA

    Marc R. Avram

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  1. Nicole E. Rogers
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Correspondence to Nicole E. Rogers .

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  1. Aesthetic Surgery, Professor, Departments of Dermatology,, Chief, Section of Cutaneous and, Feinberg School of Med, Northwestern Univ, Chicago, 60611, Illinois, USA

    Murad Alam

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Rogers, N.E., Avram, M.R. (2012). Vascular Lasers and Lights. In: Alam, M. (eds) Evidence-Based Procedural Dermatology. Springer, New York, NY. https://doi.org/10.1007/978-0-387-09424-3_12

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  • DOI: https://doi.org/10.1007/978-0-387-09424-3_12

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