Treatment endpoints for resistant port wine stains with a 755 nm laser

PubMed Reference:Izikson L, Anderson RR. J Cosmet Laser Ther. 2009 Mar. 

Study Details:

  • 5 examples of PWS tissue response endpoint
  • Resistant PWS treated with a 755 nm laser at high fluences (40-100 J/cm2), 1.5-ms pulse duration, with dynamic cooling device (40msec spray/40msec delay)
  • With increasing fluence, endpoints for sub-therapeutic to therapeutic to supra-therapeutic treatment are described.

Study Results:

Sub-optimal treatment

  • 1st endpoint: immediate deep erythema or transient purpura that evolves into tissue erythema and edema
  • 2nd endpoint: immediate slight gray color that immediately fades, produces deep erythema or faint purpura, but fails to produce deep purpura.

Optimal treatment with correct response

  • 3rd endpoint: transient gray color that gradually evolves into persistent deep purpura (Figure 2: A, B, C, D).

Supra-therapeutic treatment

  • 4th endpoint: persistent gunmetal gray color (Figure 2E - circled area). This represents overtreatment: a dermal burn that could lead to scarring.