Synergistic effect of sequential 532-nm and 595-nm lasers in port-wine stains: a randomized split-lesion trial

Pulsed dye laser (PDL) is the current gold standard for the treatment of port-wine stains (PWS), yet clearance is often incomplete even after multiple sessions. Sequential application of vascular lasers with complementary optical targets may enhance therapeutic efficacy.

To evaluate whether sequential 532-nm potassium titanyl phosphate (KTP) followed by 595-nm PDL achieves better improvement than either modality alone.

In this prospective, randomized, split-lesion trial, adults with PWS received a single laser session. Each lesion was divided into three matched regions treated with KTP alone, PDL alone, or immediate sequential KTP→PDL. The primary endpoint was blinded photographic IGA at 8 weeks. Secondary outcomes included pain, local reactions, and patient preference.

Sequential KTP→PDL achieved superior short-term improvement compared with either monotherapy, without new safety concerns. Local tolerability differed across protocols but no pigmentary alterations, scarring, or severe adverse events were observed. The sequential protocol was the preferred option in most patients.

One-session sequential 532- and 595-nm treatment demonstrated greater short-term efficacy than either laser alone with an acceptable tolerability profile. This dual-wavelength approach may optimize PWS clearance and merits evaluation in longer, multi-session studies.

NCT07015073.