Facial hypertrophic scarring from pulsed dye laser.

BACKGROUND

The 585-nm, 450-msec pulsed dye laser is widely used to treat benign vascular lesions. The biophysical interactive properties of this laser allow effective, precise small vessel ablation with very low incidence of pigmentary alteration and atrophic scarring side effects.

OBJECTIVE

We are reporting a case of hypertrophic scar development on the upper lip of a patient whose facial hypertrophic port-wine stain was treated by pulsed dye laser.

METHODS

The most effective energy fluence was determined by analysis of test areas treated at various fluences. This fluence was used for the initial full lesion treatment, with subsequent fluences chosen by treatment response at each 4-week follow-up visit.

RESULTS

After the fourth treatment a hypertrophic scar developed on our patient's left cutaneous upper lip.

CONCLUSIONS

This hypertrophic scar developed after pulsed dye laser treatment because the patient did not follow posttreatment care instructions, and because the initial treatment fluences of 8.0-8.5 J/cm2 may have been too high.