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Treatment of port wine stains with intense pulsed light: a prospective study
Wai Sun Ho1, Shun Yuen Ying, Pik Chu Chan
1Division of Plastic and Reconstructive Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Background:
Recent studies have shown that intense pulsed light can be useful in treating port wine stains that were resistant to previous pulsed dye laser therapy. Asian persons with high epidermal melanin context can be at a higher risk of complication.
Objective:
The aim of this study was to conduct a prospective trial to assess the efficacy and complication of intense pulsed light in the treatment of port wine stains in Chinese patients.
Methods:
Twenty-two Chinese patients with port wine stains without previous treatment were recruited to receive intense pulsed light source therapy for five to seven treatments at intervals of 3 to 4 weeks. Patient demographics, skin type, characteristics of port wine stains including color and location, treatment parameters, degree of pain caused by intense pulsed light treatment, percentage of clearing, and treatment complications were recorded and entered into a database. A questionnaire was conducted to assess the influence of treatment on daily activity and the intensity of pain experienced during treatment.
Results:
There were 17 female and 5 male patients. Their ages ranged from 6 to 45 years with a mean age of 21.8+/-10.1 years. More than 90% of patients had more than 25% of clearing and the majority of patients (50%) had 25% to 50% of clearing. Although 40% of the patients showed more than 50% clinical clearance, 9% of the patients were able to achieve more than 75% clearing. The only 2 patients with less than 25% clearing had nodular port wine stains and no patient was able to achieve complete clearing. The procedures were well tolerated with a mean pain score of 2.1+/-0.9 and the treatment had no influence on daily activity. One patient developed blisters and 6 patients had swelling for more than 24 hr that all resolved within 1 week without leaving permanent marks. They have been followed up from 12 to 27 months and there was no long-term complication.
Conclusion:
Intense pulsed light can be effective in treating port wine stains in Asian patients. In experienced hands, complications can be low and should be considered as one of the therapeutic options.
