BACKGROUND The use of cryogen spray cooling in the course of dye laser trea
tment of port-wine stains has established itself in recent years because of
its good analgesic and epidermally protective effects. The disadvantages o
f this kind of evaporative cooling are the cost and, in the case of dichlor
odifluoromethane, the effects on the ozone layer. Cold air is an innovative
cooling method that costs nearly nothing to use, is environmentally friend
ly, and can be easily adapted to existing laser systems.
OBJECTIVE To examine and evaluate cold air cooling as an alternative method
of cooling in laser treatment.
METHODS In a prospective study, 13 patients (9 female, 4 male) with port-wi
ne stains were treated with a pulsed dye laser (lambda = 585 nm, tau (p) =
450 mu sec). In every case, either the entire area or a sample area of the
port-wine stain was treated with cold air cooling on 50% of the surface and
without on the other 50%. Clearance, analgesia, and adverse and concomitan
t effects were assessed.
RESULTS In nine patients (69%) there were similar results in terms of clear
ance. In four cases, better lightening results (in two patients) and worse
lightening results (in two other patients) were achieved in the area treate
d with cold air. Nine of the patients (69%) felt that the laser impulses ac
companied by cold air were significantly less painful. Adverse effects (pur
pura, erythema, edema) and concomitant effects (hypopigmentation, hyperpigm
entation, scars) were much less marked in the cooled areas.
CONCLUSIONS Cold air is a safe and effective alternative to cryogen spray c
ooling. It is easy to use, economical, and environmentally friendly. Contin
uing studies are necessary to determine if there are interactions which aff
ect the tissue.