Efficacy of Pulsed Dye Laser in Facial Port-Wine Stains in Indian Patients

Abstract

Facial port-wine stain (PWS) produces severe cosmetic disfigurement and pulsed dye laser (PDL) has revolutionized the treatment of PWS. To assess the efficacy of PDL for facial PWS in Indian patients. Twenty-seven patients of Fitzpatrick skin types IV and V in the age group of 8 to 34 years (mean 21.6 years), with lesional size 3 x 1.5 to 25 x 19 cm and color from light pink to deep red and violaceous, were recruited. Laser parameters were spot size, 7 mm; fluence, 5 to 7.5 J/cm(2); wavelength, 585 nm, pulse duration, 0.45 ms; along with continuous air cooling. Response at every session was graded from 0 to 5+(0, no improvement; 1+, up to 25%; 2+, 26% to 50%; 3+, 51% to 75%; 4 +, 76% to 99%; 5+, 100% lightening). In a total of 170 sessions, maximum response of 1+ was observed in 6 patients after mean of 3.5 sessions, 2+ in 8 patients after mean of 5.25 sessions, 3+ in 8 patients after mean of 7 sessions, and 4+ improvement in 5 patients after mean of 4.8 sessions. No patient showed complete clearance. Seven patients developed hyperpigmentation while 1 patient showed hypopigmentation, but none had textural change or scarring. PDL offers significant cosmetic improvement in facial PWS in Indian patients.