SIDE-EFFECTS FROM THE PULSED DYE-LASER - THE IMPORTANCE OF SKIN PIGMENTATION AND SKIN REDNESS

The pulsed dye laser is the treatment of choice for port-wine stains. In this study me evaluate the importance of preoperative skin pigmenta tion and skin redness for the development of side effects from one tre atment with the pulsed dye laser. A risk assessment is performed and s kin reflectance measurement objectifies postoperative pigmentary chang es. Fourteen human volunteers (skin types I to V) mere laser-treated o n the inside of the proximal brachium. Photographic documentation was used for blinded, clinical evaluation of side effects 3 and 6 months p ostoperatively. Skin was artificially reddened using topical applicati on of 10% nicotinic acid cream. The development of pigmentary alterati ons and texture changes depended on the preoperative pigmentation and redness degrees. The risk of inducing clinically visible pigmentary al terations and texture changes increased with higher preoperative skin pigmentation and redness degrees, and with the application of increasi ng laser doses. Pigmentary alterations were induced at a lower fluence level than texture changes. The risk of side effects mas higher 3 mon ths postoperatively than 6 months postoperatively, substantiating a gr adual disappearance of side effects. Skin reflectance measurements doc umented postoperative hyperpigmentation that faded partially from 3 to 6 months postoperatively. This is the first human experimental model for port-wine stains which provides quantitative data on the relations hip between preoperative skin colours and postoperative clinically dis turbing side effects.