Long-pulsed neodymium:yttrium-aluminum-garnet laser treatment for hypertrophic port-wine stains on the lips.

Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan.
Journal of Cosmetic and Laser Therapy (Impact Factor: 1.11). 10/2008; 11(1):11-3. DOI: 10.1080/14764170802307940
Source: PubMed

ABSTRACT Pulsed dye laser (PDL) treatment of hypertrophic port-wine stains (PWSs) on the lips has demonstrated poor efficacy and a potential risk of dyspigmentation. PDL-resistant hypertrophic PWS may require treatment with deeper penetrating lasers such as a 1064-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. The objective of this clinical study was to evaluate the efficacy and safety of a Nd:YAG laser for the treatment of hypertrophic PWSs on the lips. Ten patients (four were male and six were female) with hypertrophic PWSs on the lips were recruited in this study. Eight patients showed good to excellent improvement without complications. In conclusion, the Nd:YAG laser is safe and effective for treating hypertrophic PWSs on the lips.

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    ABSTRACT: Background  Hypertrophic port-wine stains (PWS) usually respond poorly to pulsed dye laser treatment. The long-pulsed 1064 nm Nd:YAG laser can target deeper situated vessels and may therefore be more effective. Objective  To evaluate the efficacy and safety of the Nd:YAG laser for the treatment of hypertrophic PWS. Methods  In a retrospective cohort study, all hypertrophic PWS patients treated with the Nd:YAG laser between 2005 and 2011 were invited for follow-up. Clinical improvement was assessed using Physician Global Assessment (PhGA) and Patient Global Assessment (PGA). Results  Assessment was obtained in 32 of 44 eligible patients (mean age 51.4 years), after a mean of 2.8 (SD ± 2.1) Nd:YAG laser treatments. Good or excellent improvement of hypertrophy was found in a majority of patients, both by PhGA (91%) and PGA (93%). Good or excellent improvement of colour was found in 63% of patients by PhGA, and in 87% by PGA. Recurrence of hypertrophy was seen in three patients. All but two patients would recommend Nd:YAG treatment to other patients. Mild to moderate scars were seen in seven patients, hypopigmentation in 14 patients. Conclusion  The 1064 nm Nd:YAG laser is highly effective in the treatment of hypertrophic PWS with only a few treatments needed. Mostly mild side effects were seen in half of all patients. Hypertrophy seems to respond better than colour. To further improve colour, a combination with pulsed dye laser treatment is advisory. Observation of immediate clinical endpoints is important when using the Nd:YAG laser, to optimize outcomes and reduce side effects.
    Journal of the European Academy of Dermatology and Venereology 10/2012; · 2.69 Impact Factor
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    ABSTRACT: Abstract Background. The long-pulsed 1064-nm Nd:YAG laser is effective for treating port-wine stain (PWS). This study evaluated the efficacy and safety of Nd:YAG laser in treating PWS in Chinese patients. Methods. A retrospective study of 130 PWS patients treated with long-pulsed 1064-nm Nd:YAG laser from 2009 to 2011. Results. After treatment, 2, 15, 64, and 19% of patients experienced <25%, 25-49%, 50-75%, and >75% lesion clearance, respectively. Purple lesions showed significant improvement than did pink lesions. The initial response was blister, dark gray coloration, or light gray coloration, the best improvement occurred in 100% (27/27), 82.5% (52/63), and 72.5% (29/40), respectively. Patients older than 20 years showed the best improvement (37/38, 97.4%), followed by those 10-20 (20/24, 83.3%), 1-9 (23/29, 79.3%) and <1 year old (28/39, 71.8%). Patients with neck lesions had the best outcome (47/48, 97.9%), followed by those with lesions on the face (43/53, 81.2%), extremities (13/18, 72.2%), and trunk (5/11, 45.5%). The common adverse side effects were blister and pigment changes. Conclusions. 1064-nm Nd:YAG laser is effective and safe for the treatment of PWS. The efficacy is affected by the age of the patient, the color and location of the lesions, and immediate responses to the laser.
    Journal of Cosmetic and Laser Therapy 07/2014; · 1.11 Impact Factor
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    ABSTRACT: The response of port-wine stains (PWS) to conventional laser treatment in adults is difficult to predict. To assess the influence of local or systemic hemodynamic variables on the clearance of PWS by using flash lamp-pumped pulsed (FLPP) dye laser. All consecutive patients ages 18 years or older undergoing laser treatment for a facial PWS were eligible. Laser sessions were scheduled every 8 weeks. All patients were evaluated based on a standard scale with four evaluation categories, from no or minimal improvement to total or almost total clearance. Clearance was achieved by 50.1 % (95 % confidence interval 35.6-64.7) of patients after a maximum of 15 treatment sessions. In multivariate analysis, increased age, a newly described Type III capillaroscopic pattern, and presence of lesions in dermatome V2 were all associated with a reduced clinical response to treatment. In a model restricted to demographic pattern and patient characteristics, arterial hypertension was also associated with a lower clinical response. A strong association was found between arterial hypertension and the Type III capillaroscopic pattern. Age, arterial hypertension, capillaroscopic pattern, and body location should be considered when planning laser treatment of PWS.
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