Redarkening of Port-Wine Stains 10 Years after Laser Treatment

Abstract

To the Editor: Huikeshoven et al. (March 22 issue)1 report redarkening of port-wine stains after pulsed-dye–laser therapy. The device and fixed variables used in this study were not optimal, thus minimizing the therapeutic outcome and most likely increasing the recurrence of port-wine stains by permitting many vessels to remain unaffected by treatment.Advances in pulsed-dye–laser technology through the use of larger spot sizes, higher energy densities, varying pulse widths, and dynamic cooling allow for more effective treatment of port-wine stains through greater vessel heating and deeper vascular injury.2 The improved technology targets the heterogeneity in blood-vessel sizes that is characteristic . . .