Lasers for Vascular Lesions

Vascular skin lesions are categorized according to pathology and age of onset. Congenital lesions begin in infancy and include port-wine stains, hemangiomas, venous malformations, and lymphangiomas. Congenital lesions are found most commonly on the head or neck and may be isolated or found as part of a congenital syndrome. Acquired lesions develop in persons of any age and include telangiectasias, cherry angiomas, pyogenic granulomas, venous lakes and poikiloderma. Acquired lesions may occur spontaneously, or they may be caused by trauma, ultraviolet exposure, or hormonal changes.

The pulsed dye laser has been used successfully to treat a variety of vascular lesions due to its ability to destroy the target of vascular structures, oxyhemoglobin. These lesions include superficial vascular malformations (port-wine stains), facial telangiectasias, hemangiomas, pyogenic granulomas and poikiloderma. Vascular malformations associated with smaller more superficial blood vessels respond better to treatment than deeper larger vessels. Multiple treatments at approximately monthly intervals are often required for better results. Further treatments may be necessary if the vascular lesion recurs. Because pulsed dye laser efficacy is limited by the depth of vascular injury, deeper vascular lesions may be better treated with a more aggressive light source system.