EFFECT OF THE TIMING OF TREATMENT OF PORT-WINE STAINS WITH THE FLASH-LAMP-PUMPED PULSED DYE-LASER

Background Port-wine stains can be treated with a flash-lamp-pumped pu lsed-dye laser, but it is uncertain whether this treatment is more eff ective if administered early in life, when the skin is thinner and the lesion is smaller, Methods We prospectively studied 100 patients with a previously untreated part-wine stain of the head or neck. They were treated with the flash-lamp-pumped pulsed-dye laser and divided into four age groups (0 to 5, 6 to 12, 12 to 17, and 18 to 31 years), The o utcome measure was lightening of the port-wine stain (reduction in the difference in color between the skin with the stain and contralateral healthy skin) as measured with a colorimeter after an average of five treatments (range, three to seven) of the entire lesion. Results Of t he 100 patients, 11 could not be included in the analysis because they had received fewer than three or more than seven treatments, had an e rroneous base-line color measurement, or were lost to follow-up, The s izes, locations, and colors of the port-wine stains were similar among the groups. When all 89 patients were analyzed together, the average reduction in the difference in color between the skin with the port-wi ne stain and contralateral healthy skin was 40 percent, The difference s between age groups in the average reduction in color differences wer e not significant (P = 0.26). By the end of the study, only 7 of 89 pa tients had completed laser therapy, and in no case was clearance compl ete. Treatment was discontinued in all seven because the last three tr eatments did not lead to further lightening. Conclusions We found no e vidence that treatment of port-wine stains with the flash-lamp-pumped pulsed-dye laser in early childhood is more effective than treatment a t a later age. (C) 1998, Massachusetts Medical Society.