Adverse effects following Q-switched ruby laser treatment of pigmented lesions.

A retrospective study was conducted to investigate the incidence of adverse effects following Q-switched ruby laser treatment of pigmented lesions at the Wessex Specialist Laser Centre. Sixty-one patients received a total of 151 treatments between January 2006 and January 2008. This is the largest series to date of patients on whom adverse effects have been reported following Q-switched ruby laser treatment of an assortment of pigmented lesions. Patients with traumatic or decorative tattoos were excluded from this study. Two of the treatments (1.3%) resulted in adverse effects. One patient developed hyperpigmentation and the other experienced scabbing and subsequent textural change following abrasion of the scab. No predisposing medical or other factors were observed in either patient. This low incidence of adverse effects is consistent with the highly selective absorption of ruby laser light by melanin. The presence of these adverse effects highlights the importance of test patch treatments, the necessity for patients to follow good post-treatment advice and the case for vigilance in monitoring the quality of the laser output.

Adverse effects reported in pulsed dye laser treatment for port wine stains.

A retrospective study was conducted over a 762-day period to investigate the incidence of adverse effects following pulsed dye laser treatment for port wine stains using the Chromos 585 nm pulsed dye laser (PDL). Treatment energy densities typically ranged from 4.0 J/cm(2) to 7.5 J/cm(2). Treatment was predominantly delivered as a 7 mm-diameter pulse of laser light, although a 5 mm pulse was occasionally used. Nine patients experienced one adverse event each, with scabbing, blistering (prolonged in one case that persisted for more than 2 months), hypopigmentation or hyperpigmentation; one of the nine patients developed both blistering and hypopigmentation. The incidence of adverse effects per treatment was 1.4% (1.7% for adults and 0.6% for children). The lower leg was the most common site for an adverse effect; four out of 22 patients (18%) receiving PDL treatment for lower leg port wine stains (PWSs) suffered an adverse effect (three cases of hyperpigmentation and one of hypopigmentation and blistering). Four patients suffered an adverse effect following an increase in the energy density of the laser treatment. There was no statistically significant correlation between laser performance and the occurrence of adverse effects.

Adverse effects reported in epilatory ruby laser treatment.

A retrospective study was conducted to investigate the incidence of reported adverse responses after epilatory laser treatment to control the growth of facial hair in patients with polycystic ovary syndrome. Forty-eight patients received a median of 6 (range 2-11) treatments with an Aesculap ruby laser during a 704 day monitoring period at Salisbury District Hospital. Nine adverse skin responses such as blistering, scabbing, sustained localised erythematous reactions or hyperpigmentation were reported. The energy output of the laser was also recorded at the start of every clinical session during this period using an external energy meter. The measured energy output of the laser was plotted alongside incidents of adverse responses, although no statistically significant correlation was found. The question of whether or not some adverse effects in ruby laser treatment can be attributed to laser performance remains open.