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In the context of vitiligo treatment, the use of 308nm excimer laser therapy is a widely recognized and effective approach. However, occasionally, patients may experience blistering on the treated skin due to excessive laser dose. This phenomenon, although not common, warrants careful management to prevent complications and ensure optimal treatment outcomes. This article delves into the handling of blisters caused by excessive 308nm laser dose on vitiligo patches, providing professional guidance and detailed analysis.

Understanding the Cause

Blistering following 308nm laser treatment for vitiligo is generally attributed to excessive laser energy applied to the skin. This can lead to localized棘层海绵水肿, with inflammatory cell infiltration at the dermo-epidermal junction, ultimately causing the formation of blisters. It may also be indicative of the patient's sensitivity to the laser or inadequate dose adjustment by the physician.

Immediate Measures

Upon observing blisters, the patient should remain calm and promptly communicate with the treating physician. The following steps can be taken under medical guidance:

• General Hygiene: For small blisters without accompanying discomfort, gentle cleaning with lukewarm water and maintaining local cleanliness are sufficient. Avoid scratching or popping the blisters to prevent infection.
• Disinfection: For larger blisters or those accompanied by redness, pain, or other symptoms, sterile needles can be used to drain the fluid under medical supervision. Following drainage, the area should be disinfected with iodine or hydrogen peroxide to prevent infection.

Medical Treatment

In addition to general care, medical treatment may be necessary depending on the severity of the blisters:

• Topical Medications: Topical corticosteroids like mometasone furoate cream or hydrocortisone cream can be prescribed to reduce inflammation and alleviate symptoms such as itching and redness.
• Oral Medications: For severe cases with marked itching, oral antihistamines like loratadine or cetirizine can be prescribed to provide relief.
• Antibiotics: If infection is suspected or confirmed, oral antibiotics may be necessary to control the infection.

Long-Term Management

To prevent recurrence, the following measures are crucial:

• Dose Adjustment: The treating physician should adjust the laser dose based on the patient's response to minimize the risk of future blistering.
• Skin Protection: During and after laser treatment, the patient should protect the treated skin from further irritation or damage, including avoiding sun exposure and using moisturizers.
• Lifestyle Adjustment: Maintaining a balanced diet rich in vitamins and antioxidants, as well as ensuring adequate sleep and avoiding stress, can contribute to better skin health and treatment outcomes.

In conclusion, blistering caused by excessive 308nm laser dose on vitiligo patches, while uncommon, requires prompt and professional management. By following the outlined steps and maintaining close communication with the treating physician, patients can ensure optimal treatment outcomes and minimize the risk of complications.