Multipass Treatment of Photodamage Using the Pulse Dye Laser


Address correspondence and reprint requests to: Emil A. Tanghetti, MD, Center for Dermatology and Laser Surgery, 5601 J Street, Sacramento, CA 95819, e-mail:


Background. Pulse dye lasers (PDLs) alter structural proteins in scars and photodamaged skin, in addition to their effects on dermal vasculature. The PDL has become an option in the treatment of photodamage. Although improvements to skin texture are generally modest when compared with ablative resurfacing, PDL offers a treatment with few side effects. A number of methods have been proposed in an effort to improve treatment outcomes. These range from single, low-fluence treatment with no purpura to multiple passes and treatment sessions as well as purpuric doses.

Objective. To evaluate several of the PDL treatment methods to improve photorejuvenation outcomes while limiting the risk of side effects.

Methods. Twenty patients with photodamage were separated into two groups. Each group received a series of four single-pass treatments or four double-pass treatments at 2-week intervals. Treatments were done using a 595-nm PDL (PhotoGenica V-Star) and a 585-nm PDL (PhotoGenica V) at a pulse duration of 0.5 ms and a 10-mm handpiece. Treatment fluences were maintained below the individual's purpuric threshold, ranging from 3 to 4 J/cm2. Photos were taken before treatment and during follow-up. Efficacy of treatment was based on subjective grading of photos and by patient self-reporting.

Results. Multiple treatments resulted in improvements to skin tone and texture, including a reduction in the appearance of rhytids and, in particular, improved pigmentary evenness. There was no significant difference between laser or treatment methods. No side effects were noted.

Conclusion. PDL treatments provide effective photorejuvenation with minimal risk of side effects.