Possible hazards of cryogen use with pulsed dye laser - A case report and summary

BACKGROUND. Pulsed dye laser treatment of port-wine stains is safe and effe ctive. However, the pain associated with this treatment is often difficult to tolerate, especially for children. A laser-coupled delivery system known as dynamic epidermal cooling has recently been developed to improve local anesthesia. OBJECTIVE. TO report laser ignition of a commercially-available, hand-held cryogen spray used for local anesthesia, and describe possible mechanisms o f the fire; to define the chemical characteristics of other skin coolants s uitable and unsuitable for skin cooling with laser treatment. METHODS. Case report and literature review. CONCLUSIONS. Clinicians must be aware of the thermodynamic properties, pote ntial for skin damage, cost and environmental consequences of commercially available cryogens before considering their use for topical anesthesia with laser surgery.