The distinctive technical conditions involved combine to make IPL technology an alternative and auxiliary treatment option to existing laser systems and conventional therapies.

Objective: The flashlamp pulsed dye laser (FLPDL) is currently the treatment of choice for port-wine stains (PWS). We recently investigated whether a non-coherent intense pulsed light source (IPLS) would be effective in the therapy of PWS. Design and Patients:In order to evaluate the efficacy in treatment of PWS (especially adult-type dark and hypertrophic), a retrospective study of 37 patients (randomly selected) with a total of 40 PWS treated with IPLS was initiated. Clinical PWS characteristics recorded were color and location of the PWS. Data collected included treatment parameters (filters, pulse duration, fluence and pulse sequencing), % clearance, and side effects (purpura, blisters, crusting, altered pigmentation and scarring).Results: Good and complete (70-100 %) clearance was achieved in 28 of 40 PWS treated with IPLS. Average number of treatment sessions in PWS reaching 100 % clearance included 4.0 for pink PWS and 1.5 sessions for red PWS. Average number of sessions in purple PWS reaching good clearance (70-99%) was 4.2 sessions. Parameters used most frequently were 515 and 550 nm cut-off-filters, pulse duration of 2.5-5.0 ms and fluences of 24 to 60 J/cm 2 . Side effects included purpura in 76%, superficial blisters in 8% and crusting in 20%. Transient pigmentation changes were seen in 10.8% of patients (hypopigmentations in 8.1%, hyperpigmentation in 2.7%). No scarring was observed. Conclusion:IPLS presents an effective and safe method for treating PWS, especially dark and facial PWS.

The PhotoDerm VL is an innovative, highly effective, and comparably safe therapeutic alternative to the laser in the treatment of ETE. The rate of cosmetically relevant side effects is considerably smaller, the patient compliance is excellent, and the method can be applied easily in an outpatient setting.

The use of lasers and IPL technology in dermatology and aesthetic medicine requires practitioners not only to have high levels of training and experience, but also to exercise professional judgment. In spite of all of the precautions taken, the risk of complications and side effects can be reduced but not completely eliminated.

The sequential delivery of 595- and 1,064-nm-wavelength radiation with an interpulse delay suggests that the synergistic approach to laser therapy for facial telangiectasia is a superior method compared to standard single wavelength therapy.

Background and Objective: Due to its delicate location near the eye and the high recurrence rate, the therapy of xanthelasma palpebrarum is a difficult surgical task. Besides chemical, physical, and surgical procedures, various laser systems have been used to treat these lesions (argon laser, pulsed dye laser, and CO2 laser). This study was designed to critically evaluate the use of the ultrapulsed CO2 laser for the treatment of xanthelasma palpebrarum. Study Design / Materials and Methods:We report about the standardized treatment of 23 patients (52 periorbital xanthelasmas) and the results obtained after one treatment with a new generation, ultrapulsed CO2 laser (COHERENT Ultrapulse 5000C, Palo Alto, CA; 250-500 mJ; 600-900 µsec; 10,600 nm). The followup time was 10 months. Results: All lesions could be removed completely with a single laser treatment. As for side effects, only transient pigmental changes (4% hyperpigmentations, 13% hypopigmentations) and no visible scarring was observed. Three patients (13%) developed a recurrence of xanthelasma. Conclusions:The ultrapulsed CO2 laser is an effective and safe therapeutic alternative to the hitherto described approaches.

Background and Objective: Ablative fractional lasers were introduced for treating facial rhytides in an attempt to achieve results comparable to traditional ablative resurfacing but with fewer side effects. However, there is conflicting evidence on how well this goal has generally been achieved as well as on the comparative value of fractional CO 2 and Er:YAG lasers. The present study compares these modalities in a randomized controlled double-blind split-face study design. Study Design/Materials and Methods: Twenty-eight patients were enrolled and completed the entire study. Patients were randomly assigned to receive a single treatment on each side of the peri-orbital region, one with a fractional CO 2 and one with a fractional Er:YAG laser. The evaluation included the profilometric measurement of wrinkle depth, the Fitzpatrick wrinkle score (both before and 3 months after treatment) as well as the assessment of side effects and patient satisfaction (1, 3, 6 days and 3 months after treatment). Results: Both modalities showed a roughly equivalent effect. Wrinkle depth and Fitzpatrick score were reduced by approximately 20% and 10%, respectively, with no appreciable difference between lasers. Side effects and discomfort were slightly more pronounced after Er:YAG treatment in the first few days, but in the later course there were more complaints following CO 2 laser treatment. Patient satisfaction was fair and the majority of patients would have undergone the treatment again without a clear preference for either method. Conclusions: According to the present study, a single ablative fractional treatment session has an appreciable yet limited effect on peri-orbital rhytides. When fractional CO 2 and Er:YAG lasers are used in such a manner that there are comparable post-operative healing periods, comparable cosmetic improvement occurs. Multiple sessions may be required for full effect, which cancels out the proposed advantage of fractional methods, that is, fewer side effects and less down time.

Background and Objectives: The conventional pulseddye laser (wavelength 585 nm, pulse duration 0.5 milliseconds) is seen as the standard treatment for port wine stains (PWS). Using the pulsed-dye laser at wavelengths of 590, 595, and 600 nm and at varying pulse durations of 1.5-40 milliseconds is one of the newest developments in the field, the therapeutic value of which has been examined in only a few studies. Treatment of PWS with short-and longpulse dye lasers. Comparison of two wavelengths (585 nm vs. 595 nm) and two pulse durations (0.5 milliseconds vs. 20 milliseconds). Study Design/Materials and Methods: Fifteen patients with untreated PWS were included in a randomized prospective study with three different laser settings. Patients underwent one treatment session. The following treatment parameters were chosen at a uniform spot size of 7 mm: (1) 585 nm/0.5 milliseconds/5.5 J/cm 2 , (2) 595 nm/0.5 milliseconds/5.5 J/cm 2 , and (3) 595 nm/20 milliseconds/13 J/cm 2 . The clearance as well as side effects was evaluated. All treatments were performed with cold air-cooling. Follow-up took place immediately, 2 days and 4 weeks after the treatment. The PWS was assigned a clearance score (CS) from 1 to 4 (1 ¼ poor to 4 ¼ excellent). Results: Descriptively, 585 nm/0.5 milliseconds generated the best average CS of 2.7, followed by 595 nm/20 milliseconds (2.5) and 595 nm/0.5 milliseconds (1.6)); statistically, there is no difference between the CS of 585 nm/ 0.5 milliseconds and 595 nm/20 milliseconds. The best lightening rates overall were achieved in purple PWS (CS ¼ 3.5) versus red (CS ¼ 2.5) and pink (CS ¼ 2.0). Purple PWS responded best to 585 nm/0.5 milliseconds; red and pink PWS yielded similar results with 585 nm/0.5 milliseconds and 595 nm/20 milliseconds. The setting, 595 nm/ 0.5 milliseconds was clearly not as effective as the other laser settings. Purpura, pain, and crusting were most commonly reported after treatments with 585 nm/0.5 milliseconds (93%/93%/33%), closely followed by treatments at 595 nm/20 milliseconds (86%/93%/20%). The settings 595 nm/0.5 milliseconds yielded the lowest rate of adverse effects (67%/60%/0%). Hypopigmentation only occurred in one case (585 nm/0.5 milliseconds), and there were no reports of hyperpigmentation or scarring. Conclusions: With respect to treating PWS, the conventional pulsed-dye laser set to 585 nm/0.5 milliseconds yields a significantly greater clearance rate than it does at a setting of 595 nm (with the same pulse duration, fluence, and spot size), although the former also entails the highest spectrum of adverse effects. In this study, purple PWS treated at these parameters showed the best results. In dealing with pink PWS, the results were similar to those of the conventional pulsed-dye laser when the pulse duration was increased to 20 milliseconds and fluence was increased. As a rule, the clearance rate corresponded to the extent of the postoperative purpura.