Recent advances in laser therapy for the treatment of cutaneous vascular disorders

Abstract

The use of lasers for the treatment of cutaneous vascular disorders has expanded rapidly since its inception in the early 1960s. The flashlamp-pumped pulsed tunable dye laser (PDL), which is the best laser system for the treatment of port-wine stains (PWS), is based on the premise of selective photothermolysis. Recent literature demonstrates enhanced selective photothermolysis by modifying the PDL to include a longer pulse width, a longer wavelength and higher energy fluences through the use of dynamic cooling. Multiple pulse laser irradiation, a new innovative method, shows promising preliminary results in eradicating hypertrophic PWS. In the treatment of capillary haemangiomas, previous uncontrolled studies suggest benefit with early PDL therapy but a recent randomised controlled trial does not support this claim. Mixed haemangiomas respond poorly to PDL treatment, uncomplicated tumours are best left to involute spontaneously whilst life/organ-threatening lesions require early active intervention. The efficacy of lasers in the treatment of telangiectatic leg veins (TLV) remains controversial. The literature revealed many conflicting claims. Larger and properly controlled studies are necessary to better define the role of lasers in the treatment of TLV.