Improvement of disfiguring skin conditions by laser therapy

Since their introduction in dermatology, lasers became a welcome addition to the therapeutic armentarium for disfiguring skin conditions. In this thesis, we evaluated laser therapy for the treatment of scars, of benign dermal tumours, and of port-wine stains.
For scars, many different laser devices have been proposed. In this thesis, we performed a review that showed the pulsed dye laser most effective in hypertrophic scars. We did not find enough evidence for the efficacy of ablative fractional laser in the treatment of various scar types. Also, significant side effects have occurred in patients treated with ablative fractional lasers.
Although dermal tumours are benign, they may occur in high numbers and when they do, surgery is not an option. When timed exposure settings are used in ablative lasers, patients are offered a simple and fast treatment with uniform results, regardless of the person that controls the laser. The histological findings in this thesis complement the clinical results of timed exposure ablative laser therapy, seen in our daily practice.
For the treatment of port-wine stains, sufficient evidence has been provided that the pulsed dye laser can now be regarded as the gold standard. Since a considerable number of port-wine stains still does not respond to this treatment, parameters have been varied and other lasers have been proposed. Until now, no laser has surpassed the pulsed dye laser in the treatment of port-wine stains, although we found that the Nd:YAG laser is a good option for the treatment of hypertrophy in port-wine stains.