Dermatologist, pediatrist and aesthetic surgeon meet sometimes patients with vascular lesions as on photos 1, 3, 5, which looked as rose, red or purple stains. These examples respect to wide variety of lesions known as “port-wine stains” and hemangiomas. 1% to 3% of population with fare and dark type of skin is suffering from these lesions.
These are the "most serious" vascular lesions as they not only affect the patient's appearance, but they also negatively impact on the social and psychological health of the patient, especially when the patient is a childe or teenager. Note that capillary hemangioma cans resolve itself. However skin on it place after resolving may be notably different from the surrounding skin. Adequate treatment cans provide better cosmetic results.
Port wine stains are congenital vascular lesions consisting of ectatic capillaries and never resolves themselves. These birthmarks are present in 0.3 to 0.7 % of population and more often occur on face. For example in Moscow-city and Moscow region there are about 30 thousands of people with port-wine stain.
With ages port wine stains tend to darken in color to a reddish-purple and may develop thickening or nodularity. The risk of other complications also occurs. The treatment of port wine stains is medical necessity. And the younger age of the patient is the better.
Before using of pulsed medical lasers with yellow wavelength in dermatological practice many different treatments have been attempted, none of which were effective.
Update port wine stains and capillary hemangiomas can be successfully treated by method of selective laser coagulation and many publications present the results. Pulsed yellow light lasers such as pulse dye lasers and copper vapor lasers radiating on 578 and 585 nm wavelengths provides the best results of the treatment with minimal side-effects. The treatment is based on the principle of selective photothermolysis first discovered by R.R. Anderson and J.A. Parrish.
According to this concept, while the laser parameters satisfied to some demands, ectatic vessels consisting the lesion can be selectively heated by the laser beam and coagulate without injuring the surrounding tissue. Thus port wine stain or capillary hemangioma can be selectively remove without scarring or other serious complications.
Photos on the right represents the results of the treatment of port wine stains and hemangiomas with the copper vapor laser Yachroma-Med. As usual notable improvement is achieved after 3-5 treatment sessions even in serious cases. Not large lesions can be removed after one or two treatments. When children is treated, results are usually better than in adults. Large lesion in adult patient may be resistant to the treatment. In general case port-wine stains and hemangiomas are serious pathology, which can demand 3 – 8 treatments with 2 – 3 months intervals between them. Children younger than 6 years treated under general anesthesia. Notable advantage of Yachroma-Med is possibility of removing of vascular lesions without scarring or other complications.
Before the treatment the patients skin in the treatment area must be not insolated because melanin absorbs the laser radiance and prevents the laser light penetration into the skin to target abnormal vessels. Two weeks after treatment the patients must avoid a sun exposure or use sun protective cream with factor of protection 15 or greater.
The laser coagulation of port wine stains is performed by the method “from point to point”. The laser spots don’t overlap and small area around every treated point is left untreated. Treated areas are cleared during the procedure. In three days all treated area covers by scabs and healing continue under the scabs. In a week the scabs resolve and treated area became rose or red. Such coloration occurs about two weeks then change to light brown color for two weeks. In two or three months color of treated area became as other normal skin of the patient.
Preparing for the treatment and especially postoperative care play an important role for achieving good results. It is necessary to use anti-bacterial ointment every day during two weeks and avoid accidentally scratching off the crusts.
15-30 days after treatment you should continue to protect your face with creams offering high protection against infrared, UVA and UVB rays, and refrain from using sunlamps.
