Complete elimination of large café-au-lait birthmarks by the 510-nm pulsed dye laser.

Traditional treatment modalities for café-au-lait spots include cryotherapy, dermabrasion, and excision with or without skin grafting. These treatments have shown varying degrees of success and, in some cases, have yielded significant side effects, such as permanent pigmentary alteration and scarring. The 510-nm pulsed dye laser has been shown to selectively destroy melanosomes that make up such epidermal pigmented lesions as café-au-lait spots without significant adverse sequelae. Thirty patients with 34 large café-au-lait birthmarks received 510-nm pulsed dye laser treatments at 6- to 8-week intervals with energy densities ranging from 2.0 to 4.0 J/cm2. An average of 8.4 laser treatments were necessary to achieve complete elimination of the café-au-lait marks under study. No lesional recurrences have been observed 1 year following termination of treatment.