Side-effects and complications of flashlamp-pumped pulsed dye laser therapy of port-wine stains. A prospective study.

The flashlamp-pumped pulsed dye laser (FPDL) was the first laser system specifically developed for the treatment of cutaneous vascular lesions such as port-wine stains (PWS), telangiectases and haemangiomas. Its theoretical advantages have been verified by numerous excellent clinical results. As there are few systematic studies on the adverse effects of this laser system, we investigated 100 consecutive patients who received FPDL therapy of PWS. Pain during and after laser therapy was a common complaint. Post-treatment erythema occurred in 29%, oedema in 73%, formation of bullae in 1%, and serous crusting in 46-83% of patients (based on our observations and the patients histories, respectively), all of which lasted for a maximum of 7 days. Furthermore, complications such as impetigo-like crusting occurred in 25%, bleeding in 12%, a pyogenic granuloma in 1%, hyperpigmentation in 27%, hypopigmentation in 1%, atrophic scarring in 3%, and an hypertrophic scar in 1%. Although most of these changes were only focal, and were predominantly transient, our results indicate that the incidence of side-effects and complications produced by the FPDL (wavelength 585 nm, pulsewidth 450 microseconds) may be higher than previously documented in the literature.