Investigation into optimal treatment intervals of facial port-wine stains using the pulsed dye laser

Background: Port-wine stains (PWS) affect 0.3% to 0.5% of newborns and pulsed dye laser (PDL) remains the treatment of choice. Optimal treatment intervals have not been established. Objective: We sought to validate the optimal treatment intervals for the management of facial PWS with PDL. Methods: In all, 24 infants with facial PWS who received at least 5 treatments with the PDL at 2-, 3-, and 4-week intervals at a private laser and skin surgery center from 2009 to 2010 were identified by a retrospective chart review. Safety and efficacy were compared by blinded investigators. Results: Side effects were equivalent in all interval groups and included only expected short-term erythema, edema, purpura, and mild postinflammatory hyperpigmentation. No patient developed hypopigmentation, scarring, or infection. All interval groups showed 50% to 100% clearance of their PWS after 5 treatments. Complete or near-complete clearance was seen in 6 of 8 (75%) and 7 of 8 (87.5%) patients in the 2- and 3- week interval groups, respectively, as compared with 3 of 8 (37.5%) patients in the 4-week interval group. Limitations: This was a retrospective chart review from a single institution. Long-term side effects and recurrence rates were not assessed. Conclusion: We conclude that PDL treatments at 2-, 3-, and 4-week intervals are effective for the management of facial PWS in infants with minimal short-term side effects. Shorter treatment intervals may allow for relatively more rapid and more effective treatment. (J Am Acad Dermatol 2012;67:985-90.)