Cutaneous vascular disorders: advances in laser treatment

The treatment of cutaneous vascular disorders has been undergoing revolutionary changes with the advent of a new generation of highly specific laser systems. Utilizing yellow laser light, it is now possible to destroy ectatic vascular lesions selectively with minimal or no damage to other cutaneous structures. Improved clinical results, reduced pain, and greatly decreased risk of scarring now allow outpatient treatment of patients at any age and with lesions at any anatomical location often using either local or no anesthesia. Children with port-wine stains can now be safely treated before they sustain serious psychological damage. Almost all vascular skin lesions can be significantly lightened or removed using yellow laser light therapy. Often the treated areas return to completely normal-appearing skin. New topical anesthetics and automated, "robotic" laser scanning devices allow faster, less painful, and more cost-effective treatment. This article critically examines available treatment options, and the indications for and limitations of these treatments.