Laser and Light Treatment of Acquired and Congenital Vascular Lesions

Abstract

CHAPTER SUMMARY • Lasers and light sources are the treatments of choice for a variety of congenital and acquired cutaneous vascular lesions. • Based on the principles of selective photothermolysis, laser lights induce photocoagulation of vessels by using wavelengths well absorbed by hemoglobin. • Appropriate pulse durations, equal to or shorter than the thermal relaxation time of the vessels, are chosen to confine the thermal damage. • Lights with longer wavelengths have increased optic penetration and are employed to target deeper dermal vessels. • Epidermal cooling techniques can protect against epidermal injury and improve treatment efficacy by allowing use of higher fluences. • Light-based treatments can be used effectively in the skin of color, but special caution should be made to prevent complications. • Fractional photothermolysis has a potential role in treating hypertrophic portwine stains and involuted hemangiomas. • Photodynamic therapy works by activation of photosensitizer by light sources and can be used to treat recalcitrant or nodular portwine stains. • Lesions treated with light sources include portwine stains, infantile hemangiomas, telangiectasia, facial erythema, poikiloderma, hypertrophic scars and leg veins.