What is the role of pulsed-dye laser (PDL) (595 nm) in the treatment of keloids and hypertrophic scars?

Updated: Jun 12, 2018
  • Author: Brian Berman, MD, PhD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Two studies have demonstrated that the 585-nm PDL has more effectively cleared port-wine stains than the 595-nm PDL at the same settings. Murine studies determined that the beneficial effect of lasers inhibiting the scar tissue growth decreased as the wavelength of the laser was increased from 585 to 600 nm. Further studies are necessary to obtain similar conclusions in human tissue. However, longer wavelength (eg, 595 nm) is an alternative vascular-specific laser for dark-skinned patients, with higher amounts of epidermal melanin, which absorbs more readily the 585-nm wavelength, causing nonspecific damage to pigmented epidermis. Currently, 595-nm PDL systems incorporate in the handpiece a cryogen-spray cooling device, which permits safe and effective treatment of hypertrophic scars by raising the threshold for epidermal damage, avoiding the resultant epidermal necrosis when the skin surface temperatures exceeds 70°C immediately after PDL exposure.


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