Application of short-pulsed CO2 laser and long-pulsed Nd:YAG laser in the treatment of severe hypertrophic port-wine stains

Background

The treatment of port-wine stains (PWS) becomes extremely difficult due to age-related malformation of the vasculature. In this study, we used alternative methods to treat hypertrophic PWS.

Methods

A short-pulsed CO₂ laser was applied to ablate the hypertrophic vasculature of PWS. The ablation was ended when the wound was on the same plane as normal skin. The long-pulsed neodymium-doped yttrium-aluminum-garnet (lpNd:YAG) laser was primarily applied to coagulate and subsequently liquefy the hypertrophic vasculature of the PWS. The therapeutic energy used in treating different lesions should be carefully regulated to significantly affect the treatment outcomes.

Results

The two cases presented herein demonstrated substantial improvement in hypertrophic vasculature that was largely removed. The skin was resurfaced, although some scar formation and mild hypopigmentation occurred.

Conclusion

We suggest the use of short-pulsed CO₂ and lpNd:YAG lasers for treating certain cases of hypertrophic PWS. When using a short-pulsed CO₂ laser, it is wise to judge the treatment endpoint and take appropriate precautions to avoid intraoperative bleeding. When using an lpNd:YAG laser, the therapeutic energy should be controlled according to the thickness of the lesion to reduce scar formation.