The use of the indications of the laser in treating
vascular malformations and infantile haemangiomas is
based on the theory of selective photothermolysis, in
which the oxyhaemoglobin is the target chromophore
on which the light of the laser acts, thus avoiding damage
to neighbouring tissues. The pulsed dye laser is the
most employed and at present is the treatment of
choice in capillary malformations (port-wine stains). A
variable response is obtained, with a substantial clearing
of the colour of the lesion after several sessions.
Application at early ages seems to improve the results.
Venous malformations, especially those localised in
the mucosa, respond better to the Nd:YAG laser; lymphatic
malformations to the CO2 laser. Arteriovenous
malformations rarely respond. Use of the pulsed dye
laser in the phase of proliferation of the haemangiomas
is subject to controversy, except where there is ulceration.
A rapid re-epithelialization is obtained in these
cases following its use. In the involution phase,
patients with residual vascular lesions can benefit from
other lasers such as KTP or Nd:YAG. If they show an
atrophic surface and scars these complications
improve with the CO2 laser or Er:YAG. New treatment
modalities are emerging, such as photodynamic therapy,
whose efficacy and safety, both in the treatment of
haemangiomas and vascular malformations, have yet
to be confirmed
