Treatment of port wine stains with the pulse dye laser

The pulsed dye lasers (PDL) are the gold standard in the treatment of port wine stains (PWS). However, clearance rates vary widely, and many lesions are not completely cleared with laser treatment. This article reviews the use of different types of PDL for the treatment of PWS. Longer pulse durations and higher fluences in conjunction with skin cooling are required for larger vessels. Controversy still exists as to which wavelength induces greater photothermal damage to the blood vessels in PWS. The incomplete response of PWS to the conventional PDL is due to the suboptimal irradiation parameters of energy fluence, pulse duration, and wavelength currently used in clinical settings. New-generation PDL are more effective than conventional PDL, but vessels smaller than 30-50 microm appear resistant to all kinds of PDL treatment.