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People who have laser treatment for port wine stains should be warned that the stain can gradually darken again after treatment. Researchers found considerable darkening, often obvious to the naked eye, in 51 patients nearly 10 years after their original five laser sessions. On average, the stains had darkened despite the extra laser sessions undertaken by most of the patients. Although the stains were better than before treatment, only 30 of the 51 patients were happy with the long term result.
Others have also reported the recurrence of port wine stains over time. But no one is sure why it happens. Theories include angiogenesis from the deep layers of the stain that remain after treatment, natural darkening with age, or neovascularisation caused by the original treatment.
Whatever the cause of recurrence, advances in laser technology may overcome it. Newer generations of pulsed dye lasers now use longer wave lengths, higher energy pulses, and cryogen spray cooling, say the researchers. Long term follow-up of patients using objective colour analysis is the best way to tell if these extras have any impact on the eventual cosmetic result.