Histologic responses of port-wine stains treated by argon, carbon dioxide, and tunable dye lasers. A preliminary report

Although the blue-green argon laser light has been used successfully to treat port-wine stains (PWSs) for many years, it produces substantial epidermal damage. We have previously shown in normal human skin that pulsed yellow tunable dye lasers (577-nm wavelength) can cause highly selective damage to cutaneous microvessels with minimal injury to the overlying epidermis. Pulsed tunable dye lasers also produce selective vascular injury in the abnormal vessels of PWSs, with clinically apparent lightening of the lesions. Both epidermal injury and fibrosis are less severe with this laser treatment than with argon and carbon dioxide laser treatments. Clinical and histologic responses of PWSs treated by argon, CO2, and pulsed yellow dye lasers were compared and followed up for one month in three patients. Although larger and longer-term clinical trials are necessary to fully evaluate this new treatment modality, it appears that pulsed yellow laser radiation offers a more selective, less traumatic, and probably superior form of treatment for PWSs.