Pigmentation-dependent side effects to copper vapor laser and argon laser treatment

Melanin is a limiting factor for obtaining beneficial results in dermatological treatment of vascular malformations. The aim of our study was to establish a relation between pretreatment skin pigmentation and the occurrence of side effects.

Thirteen human volunteers selected to have a varying degree of skin pigmentation were laser-treated on the inside of the brachium with an argon laser (AL, 488 nm and 514.5 nm) and a copper vapor laser (CVL, 578 nm), both connected to a Hexascan. Total exposure areas were 1.26 cm2 and beam diameters were 1 mm. Three intensities were used, 0.7, 1.0, and 1.3 W. Pulse duration was 200 ms, resulting in fluences of 17.8, 25.5, and 33.1 J/cm2. Pretreatment skin pigmentation was objectified by skin reflectance measurements.

At 1, 2, and 6 months after laser treatment, significant correlations were demonstrated between pretreatment skin pigmentation and laser-induced pigmentary changes and scar formation. At the 6-month assessment, the AL induced significantly higher scores of clinically evaluated scar formation as compared with the CVL (1.0 and 1.3 W/spot) and tended to induce higher clinical scores of pigmentary changes (not significant, ns).

We recommend skin pigmentation to be taken into consideration in dermatological laser treatment of vascular malformations.