The effect of cold air cooling on 585 nm pulsed dye laser treatment of port-wine stains

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.