Port-wine stains unresponsive to pulsed dye laser: explanations and solutions.

The flashlamp-pumped pulsed tunable dye laser has represented a significant advance in the treatment of port-wine stains (PWS). However, not all patients will respond. In this review, the clinical features influencing the response of PWS to the pulsed dye laser will be discussed. Theoretical and clinical data are presented to explain why not all PWS will respond to this laser. Methods to overcome the problems of non-responding PWS are suggested, including new treatment devices and techniques.