The best cosmetic results for large capillary (port wine) hemangiomas are achieved by -

Pulsed dye laser (PDL) therapy is considered the standard of care for the treatment of capillary malformations. It is based on the concept of selective photothermolysis.. The beam is selectively absorbed by red- pigmented material such as hemoglobin in the blood vessels of the lesion. This produces selective heat destruction of capillary vessel walls with minimal damage to the overlying epidermis, which leads to the lightening of the port wine stain without scarring. "The best treatment to date for early and intermediate port wine stains is with the pulsed dye laser. The method of treatment is termed selective photothermolysis. The beam is selectively absorbed by red- pigmented material such as haemoglobin in the blood vessels of the lesion. This produces selective heat destruction of these structures, and the treated area becomes whiter."- CSDT 13/e Capillary malformations (port wine stains or nevus flammeus) Capillary malformations (port wine stains or nevus flammeus) are low-flow vascular malformations of dermal capillaries and postcapillary venules. They are present at birth as blanchable pink to red patches. They may be located anywhere on the body, most commonly on the face, typically with a unilateral or segmental distribution that respects the midline. On the face, they tend to follow the distribution of the trigeminal nerve branches (segments V1 , V2 , and V3 ) Capillary malformations do not regress, but grow in proportion to the child's growth and become thicker and darker in colour during adulthood.