Noninvasive pulsed dye laser is the current gold standard for the treatment of port wine stains. However, most port wine stains are not completely cleared after pulsed dye laser therapy, owing to insufficient photocoagulation and laser-induced vascular regeneration and reperfusion. Several studies have explored approaches designed to improve treatment efficacy. This integrative literature review summarizes the results of clinical and animal studies published between 2004 and 2021. Pulsed dye laser has been administered in combination with photoelectric devices (the neodymium: yttrium-aluminum-garnet lasers, dual-wavelength 1064-/595-nm laser irradiation, fiberoptic Nd-YAG laser, photodynamic therapy, and radio frequency), and drugs (rapamycin, imiquimod, timolol, axitinib, endothelin receptor antagonist, artificial red blood cells and oxymetazoline). The initial results suggest that combination therapy is a direction worth exploring in the future. Further large prospective, blinded and controlled multicenter clinical trials with longer follow-up period are required to obtain more robust evidence.
Keywords: Pulsed dye laser; combined therapy; photodynamic therapy; port-wine stains.