The treatment of vascular and pigmented lesions has been greatly improved since the
introduction of laser technology. Utilizing the principles of selective photothermolysis,
physicians can be very specific in their treatment, maximizing injury of the selected
target and minimizing damage to surrounding structures. Treatment of vascular lesions
is accomplished with a variety of wavelengths. The pulsed-dye laser system remains
the gold standard with which all others are compared. A variety of advances in technology
in recent years have greatly improved laser treatments. These include the addition
of longer pulse widths, variable spot sizes, and a variety of skin-cooling techniques.
With today's laser technology, most facial telangiectasias can be treated in a single
session with minimal downtime. Angiomas often require more than one treatment. Port
wine stains and hemangiomas still require multiple treatments, but treatment sessions
are less painful and recovery is quicker. The treatment of pigmented lesions has also
improved with new technology. Q-switched systems provide optimal treatment for most
pigmented lesions. In general, superficial pigmented lesions are treated with shorter-wavelength
systems, and deeper lesions are treated with longer-wavelength systems. The CO2 laser continues to have a role in difficult-to-treat lesions.
KEYWORDS
Vascular - pigmented - laser - telangiectasia - lentigines
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Mark M HamiltonM.D.
Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine
170 West 106th Street, Indianapolis, IN 46290
Email: Mmckhamilton@aol.com