Abstract
Based on the well-known principle of selective photothermolysis, laser has been a promising way for the treatment of port wine stains (PWSs). The laser wavelengths used for PWS’s clinical treatment include but are not limited to pulsed dye laser (PDL) in 585–600 nm, long-pulse 755-nm alexandrite, and 1064-nm Nd:YAG lasers. The objective of this study was to investigate the optimal wavelength for PWS’s laser treatment. A two-scale mathematic model was constructed to simultaneously quantify macroscale laser energy attenuation in two-layered bulk skin and microscale local energy absorption on target blood vessels within Krogh unit. The effects of morphological parameters, including epidermal melanin content, epidermal thickness, dermal blood content, blood vessel depth, and diameter on laser energy deposition within target blood vessels, were investigated from the visible to near-infrared bands (500–1100 nm). The energy deposition ratio of target blood vessel to epidermal surface was proposed to determine the optimal laser wavelength for PWS with different skin morphological parameters. The bioheat transfer modeling and animal experiment are also conducted to prove our wavelength optimization. The optimal wavelengths for lightly pigmented skin with small and shallow target blood vessels are 580–610 nm in the visible band. This wavelength coincides with commercially used PDL. The optimal wavelength shifts to 940 nm as the epidermal pigmentation increases or the size and blood vessel depth increases. The optimal wavelength changes to 1005 nm as the epidermal pigmentation or the size and burying depth of target blood vessel further increases. Nine hundred forty nanometers can be selected as a general wavelength in PWS treatment to meet the need in most widely morphological structure. Lasers with wavelengths in the 580–610, 940, and 1005 nm regions are effective for treating PWS because of their high optical selectivity in blood over the epidermis.
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References
Jacobs AH, Walton RG (1976) The incidence of birthmarks in the neonate. Pediatrics 58:218–222
Landthaler M, Hohenleutner U (2010) Laser therapy of vascular lesions. Photodermatol Photoimmunol Photomed 22:324–332
Chang HS, Kim YG, June HL (2006) Treatment using a long pulsed Nd: Yag laser with a pulsed dye laser for four cases of blebbed port wine stains. Ann Dermatol Suppl 1(23):S75–S78
Anderson RR, Parrish JA (1983) Selective photothermolysis precise microsurgery by selective absorption of pulsed radiation. Science 220:524–527
Sivarajan V, Maclaren WM, Mackay IR (2006) The effect of varying pulse duration, wavelength, spot size, and fluence on the response of previously treated capillary vascular malformations to pulsed-dye laser treatment. Ann Plast Surg 57(1):25–32
Kelly KM, Choi B, McFarlane S et al (2005) Description and analysis of treatments for port-wine stain birthmarks. Arch Facial Plast Surg 7(5):287–294
Desmyttere J, Grard C, Stalnikiewicz G, Wassmer B, Mordon S (2010) Endovenous laser ablation (980 nm) of the small saphenous vein in a series of 147 limbs with a 3-year follow-up. Eur J Vasc Endovasc Surg 39:99–103
Li L, Kono T, Groff WF et al (2018) Comparison study of a long-pulse pulsed dye laser and a long-pulse pulsed alexandrite laser in the treatment of port wine stains. J Cosmet Laser Ther 10(1):12–15
Yang MU, Yaroslavsky AN, Farinelli WA, Flotte TJ, Rius-Diaz F, Tsao SS, Anderson RR (2005) Long-pulsed neodymium:yttrium-aluminum-garnet laser treatment for port-wine stains. J Am Acad Dermatol 52:480–490
Ying ZX, Zhao YB, Li D, Shang YL, Chen B, Jia WC (2020) The influence of morphological distribution of melanin on parameter selection in laser thermotherapy for vascular skin diseases. Lasers Med Sci 35(10):901–917
Verkruysse W, Lucassen GW, deBoer JF, Smithies DJ, Nelson JS, van Gemert MJC (1997) Modeling light distributions of homogeneous versus discrete absorbers in light irradiated turbid media. Phys Med Biol 42:51–65
Milanic M, Jia WC, Nelson JS, Majaron B (2011) Numerical optimization of sequential cryogen spray cooling and laser irradiation for improved therapy of port wine stain. Lasers Surg Med 43:164–175
Li D, He YL, Wang GX, Wang YX, Ying ZX (2013) A new model of selective photothermolysis to aid laser treatment of port wine stains. Chin Sci Bull 58:416–426
Krogh A (1919) The number and distribution of capillaries in muscles with calculations of the oxygen pressure head necessary for supplying the tissue. J physiol 6:409–415
Li D, Chen B, Ran WY, Wang GX, Wu WJ (2015) Selection of voxel size and photon number in voxel-based Monte Carlo method: criteria and applications. J Biomed Optics 20(9):095014
Dai T, Pikkula BM, Wang LV et al (2004) Comparison of human skin opto-thermal response to near-infrared and visible laser irradiations: a theoretical investigation. Phys Med Biol 49:4861–4877
Jacques SL (1998) Skin Optics Summary. http://www.omlc.ogi.edu/news/jan98/skinoptics.html. Accessed April 2021
Jacques SL, McAuliffe DJ (1991) The melanosome: threshold temperature for explosive vaporization and internal absorption coefficient during pulsed laser irradiation. Photochem Photobiol 53(6):769–775
Bosschaart N et al (2014) A literature review and novel theoretical approach on the optical properties of whole blood. Lasers Med Sci 29(2):453–479
Verkruysse W, Pickering JW, Beek JF, Keijzer M, van Gemert MJC (1993) Modeling the effect of wavelength on the pulsed dye laser treatment of port wine stains. Appl Opt 32:393–398
Van Gemert M et al (1989) Skin optics. IEEE Trans Biomed Eng 36(12):1146–1154
Barsky SH, Rosen S, Geer DE, Noe JM (1980) The nature and evolution of port wine stains: a computer-assisted study. J Invest Dermatol 74:154–157
Passeron T, Olivier V, Duteil L, Desruelles F, Fontas E, Ortonne J (2003) The new 940-nanometer diode laser: an effective treatment for leg venulectasia. J Am Acad Dermatol 48(5):768–774
Kaudewitz P, Klovekorn W, Rother W (2001) Effective treatment of leg vein telangiectasia with a new 940 nm diode laser. Dermatol Surg 27:101–106
Tierney E, Hanke CW (2009) Randomized controlled trial: comparative efficacy for the treatment of facial telangiectasias with 532 nm versus 940 nm diode laser. Lasers Surg Med 41(8):555–562
Li D, Farshidi D, Wang GX, He YL, Kelly KM, Wu WJ, Ying ZX (2014) A comparison of microvascular responses to visible and near-infrared lasers. Lasers Surg Med 46:479–487
Li D, Chen B, Wu WJ, Wang GX, He YL, Ying ZX (2014) Experimental investigation on the vascular thermal response to near-infrared laser pulses. Lasers Med Sci 30:135–145
Li D, Li R, Jia H et al (2017) Experimental and numerical investigation on the transient vascular thermal response to multi-pulse Nd: YAG laser. Lasers Surg Med 49(9):852–865
Li D, Zhang H, Chen B et al (2020) Experimental investigations on thermal effects of a long-pulse alexandrite laser on blood vessels and its comparison with pulsed dye and Nd:YAG lasers. Lasers Med Sci 35(7):1555–1566
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This study was funded by the National Natural Science Foundation of China (grant number 51976170, 51727811).
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All procedures involving animal experiments were approved by the Institutional Animal Care and Use Committees of the Xi’an Jiaotong University.
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Li, D., Wu, W.J., Li, K. et al. Wavelength optimization for the laser treatment of port wine stains. Lasers Med Sci 37, 2165–2178 (2022). https://doi.org/10.1007/s10103-021-03478-9
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DOI: https://doi.org/10.1007/s10103-021-03478-9