What Do They Look Like
Port-wine stains vary in size from a few millimetres across to a big patch covering almost all of one half of someone’s face. Their colour can vary from pale red to deep purple.
The picture below shows an adult’s hand. Stain colour is often lighter in babies, as port-wine stains tend to darken with age:
What Happens To Port
Unlike some other birthmarks, such as a “stork bite” or “strawberry,” a port-wine stain grows as the child grows. The birthmark will last into adulthood. The color usually gets darker, turning purple or a deep red. The skin of a port-wine stain often gets thicker, and it may go from feeling smooth to pebbly.
The birthmark shouldn’t itch or hurt, and it shouldn’t bleed. If it does, you should have it checked by a doctor. Sometimes, a port-wine stain gets drier than the skin around it, and using moisturizer will help.
When Is The Best Time To Treat A Port
Most port-wine stains are quite pale and flat in a newborn. If left alone they gradually get thicker, bumpy and darker. This is why early treatment, in a young child, is better than in an adult.
Further reading and references
Rajaratnam R, Laughlin SA, Dudley D Pulsed dye laser double-pass treatment of patients with resistant capillary malformations. Lasers Med Sci. 2011 Apr 8.
Klein A, Baumler W, Landthaler M, et al Laser and IPL treatment of port-wine stains: therapy options, limitations, and practical aspects. Lasers Med Sci. 2011 Mar 10.
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How To Help Your Child Cope With A Birthmark
A good first step in helping your child cope with a birthmark is to demonstrate your own acceptance. Children are very good at sensing their parents feelings if you truly believe your child is wonderful and that a birthmark does not define him/her, your child will be more likely to adopt this point of view. Some people will stare or ask questions. A big smile is a great way to break a stare. Try having some simple responses ready to go in these situations, such as Its just a birthmark, it doesnt hurt or keep him from having fun. What kinds of games do you like to play? This type of response, said in a matter-of-fact tone, allows you to give information to curious people but also keeps the conversation moving away from differences and towards shared interests.
Encourage your child to make friends with people who are kind, supportive and accepting of his or her differences. After all, differences are what make us unique. As the good Dr. Seuss once said, Why fit in when you were born to stand out?
For more information about Nationwide Children’s Hospital’s Hemangioma and Vascular Malformations Clinic, .
How Can Port Wine Stains Be Treated
Although it can be useful for a child with a port wine stain to see a specialist doctor soon after birth, treatment does not usually start until later in infancy. There are currently two options for treating port wine stains: laser treatment and cosmetic camouflage.
Laser treatment, with a pulsed dye laser, is currently the treatment of choice for fading a port wine stain. It may also help the ‘cobblestone’ effect that can develop in adulthood. When laser treatment is carried out at a specialist centre, who are experienced in dealing with vascular birthmarks in children, the results can be excellent and the side effects minimal.
What is laser treatment and how does it work?
Laser treatment uses a narrow beam of light that is absorbed by the red colour in the blood vessels in the port wine stain. This is called selective photothermolysis, which means that the specific area of tissue containing blood vessels is treated using light that in turn produces heat .
Each time the laser beam touches the skin, it treats a small area only a few millimetres across. We call this a laser dot and most children have lots of dots in one laser treatment session.
How long does laser treatment take?
The first stage in the treatment process is usually a test patch, which shows how well the childs birthmark responds to the laser. Most of our children have a test patch, but if the port wine stain is very small, it might not be needed.
What happens afterwards?
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What Causes Port Wine Stains
When an area of a childs skin fails to receive enough nerve fibers during gestation, blood vessels cannot develop normally and expand instead. This allows too much blood to enter capillaries, which continue to expand to accommodate greater amounts of blood. Eventually, a purplish-red port wine stain develops as a result of these engorged capillaries. This excess blood is why PWSs are so much darker than other areas of skin containing normal amounts of nerve fibers and blood flow.
How Can Parents Help
Port-wine stains can get very dry sometimes, so it’s important to use a moisturizer on the affected skin. Call the doctor if your child’s port-wine stain ever bleeds, hurts, itches, or gets infected. Like any injury where there is bleeding, clean the wound with soap and water and, using a gauze bandage, place firm pressure on the area until the bleeding stops. If the bleeding doesn’t stop, call the doctor.
If your child’s port-wine stain was treated with laser surgery, avoid rubbing or scratching the area. Gently clean it with lukewarm water and follow your doctor’s instructions for care of the treated area. Usually, this means putting an antibiotic ointment on it for the first few days, followed by moisturizing.
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Birthmarks: Complications Of Port
Port-wine stain birthmarks are named for their color. The color is similar to that of port wine. This type of birthmark belongs to a family of vascular disorders, in which the port wine color is created by the dilation of capillaries deep in the skin. Port-wine stains usually appear on the face at birth or shortly thereafter, but, they can appear anywhere on the body. As the child grows, the birthmark may enlarge and deepen in color. In adulthood, the affected area tends to thicken.
The condition may have a psychological and social impact for some individual, but it is usually medically benign. In rare cases, port-wine birthmarks may indicate a more serious condition.
What Is The Outlook For Children With Port Wine Stains
If a childs port wine stain was treated with a laser, we expect to see a significant improvement in its appearance, although it will not disappear completely. In our experience, 70 per cent of children having laser treatment will see an improvement in colour of about 70 per cent, that is, nearly three quarters of children will have a much lighter colour birthmark after a course of four to six laser treatments.
A small number of children have a less good response to laser treatment, with little fading. The success of laser treatment varies depending on the part of the body affected and the depth of the abnormal blood vessels. In our experience, the laser works best on port wine stains that are bright pink or red and less well if the port wine stain is purple. Port wine stains on the face generally respond better than port wine stains on the trunk or legs, but as each child is different, we still suggest trying laser treatment.
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Progression Can Occur When Port
Over time, port-wine birthmarks , can darken, thicken, and develop raised bumps and ridges. When left untreated, port-wine birthmarks can also result in specific long-term conditions that may need further treatment. Examples include:
- Soft tissue hypertrophy develops when the tissue beneath a port-wine birthmark spreads or enlarges. This occurs most commonly around the lips.
- Cobblestoning skin thickening that develops as a result of malfunctioning capillaries.
- Bleeding the skin of a port-wine birthmark may be prone to bleeding when injured or scratched.
- Vascular blebs grape-like growths of small blood vessels that can develop from port-wine birthmarks. They may bleed and may need to be removed.
What To Expect At Your Birthmark Treatment
Lasers have made a huge impact on treating port-wine stains. Most of these birthmarks respond well to treatment with a pulsed dye laser. This is because these lasers can reduce blood vessels near the skin without significantly damaging the skin itself. The concentrated beam of light lightens the appearance and softens the texture of these birthmarks.
Port-wine stain birthmark treatments typically require several sessions to achieve the desired results. It is important to remember that laser treatments may not completely remove a birthmark, but they will almost always lighten the color and make the spot less noticeable. Directly after the treatment, your skin will be sensitive for a couple of days. Wear sunscreen, try to keep out of the sun, and protect the treated skin.
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What Is The Difference Between A Port Wine Stain And A Birthmark
A port wine stain is actually a type of birthmark. However, most other types of birthmarks may not require treatment because they usually fade over time. Common birthmarks that do not involve capillary malformation found in PWSs include:
- Salmon Patchalso called anangel kiss or stork bite, the salmon patch birthmark is seen on nearly half of all babies born. Usually appearing on the forehead, back of the head neck or eyelids, a salmon patch is pinkish, irregularly shaped and harmless. Most fade by the time the child is five years old and do not need removed.
- Strawberry Hemangiomathis birthmark is rarer than port wine stains, occurring in about one out of every 400,000 births each year. Although a strawberry hemangioma may not be present at birth, it will emerge shortly after birth as a raised, red patch of skin resembling a strawberry in color and size. Although these vascular birthmarks enlarge rapidly during a babys first year, they are harmless and eventually disappear in about 70 percent of children affected by them. However, if a strawberry hemangioma is located in a visible areathe face or neck, for exampleit may need removed to prevent self-esteem issues from affecting the child if it does not fade in time.
Port Wine Stain Birthmark Removal Through Surgery
Many port wine stain birthmark removal techniques have been tried over the years. These have included radiation, surgery and freezing. Tattooing has also been a way of concealing the birthmarks. While surgery may work in birthmarks that have grown too large with time, it normally is not the best choice.
Surgery is used for port wine stain birthmark removal when they have grown too large and are no longer smooth. This though can be prevented if treatment is done in the early years. The treatment will get rid of the birthmark and it will not be necessary to carry out birthmark removal procedures.
At this age, the stain will still be smooth enough to be treated using laser treatment therapy which is the most successful means of eliminating port wine birth marks. This method is safe enough for small babies and causes minimal if any damage to the skin.
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Red Purple Or Dark Marks
- are red, purple or dark marks and usually on the face and neck
- are present from birth
- look like very dark patches on dark skin
- usually affect one side of the body, but can affect both
- can sometimes be made lighter using laser treatment
- can become darker and lumpier if not treated
- can be a sign of Sturge-Weber syndrome and Klippel-Trenaunay syndrome, or macrocephaly-capillary malformation, but this is rare
Port Wine Stain Complications
Apart from an unwanted stain or lesion on the skin, benign port wine birthmarks hardly cause any complication. However, if these stains are caused by genetic mutation following complications can crop up in the adulthood
- Eye problems: The main reason behind eye problem is the port-wine stains in the eyelid area. Its important to keep a stern watch on the development of the stains since childhood, so that the risk of blindness can be averted right the very beginning.
- Brain abnormalities: Though pretty uncommon, the chance of brain abnormalities following a port wine stain can be dangerous. Dermatologists believe that the extensive blood vessel abnormalities in the brain can have significant effect on the brain development of the child. In rare cases, epilepsy and various other nervous problems can develop.
- Spine abnormalities and varicose veins: These are mainly noticeable due to the abnormalities of the Varicose veins, which poses serious health hazard as the child grows.
However, the good news is, most of the kids do not get any complications when they grow up. However, a medical emergency is sought after, to check if theres any chance of malignancy.
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Port Wine Birthmark Cause
The main port wine birthmark cause is a localization of faulty blood vessels. These may result from damaged nerve supply to the blood vessels. This makes the blood capillaries to remain dilated all the time since the nerve impulses responsible for dilation and constriction of the vessels are lost. As a result, there is a greater than normal blood flow which leads to formation of a stain beneath the skin. Exposure to ultraviolet light may cause port wine stains to develop later after birth.
Why Choose Zel
At Zel Skin & Laser Specialists, we believe your skin is too important to leave to chance. We use the most advanced laser technologies and conduct our own internal research to prove our birthmark treatments will be effective.
We are a dermatologist-owned and dermatologist-directed clinic, and weve invested in more laser technology than any other clinic in the Twin Cities. Our goal is to help you achieve your skins best appearance with a comprehensive, life-long approach to caring for your skin. If youre interested in getting treatment for your port-wine birthmark, or if your birthmark appears suspicious in any way, make an appointment.
Felt COvid safe … always a great experience working with professionals Shelley McDonald
Dr. Zelickson is thorough and patiently attentive to my concerns. Such a great practice and so easy to deal with. A great emphasis on safety during this pandemic which I really appreciate.
Everyone I have met at Zel is amazing! Anne Vournakis
Dr. Brian Zelickson was one of our initial Thermage investigators and helped us understand the mechanisms of noninvasive skin tightening. He is a renowned expert on how collagen can affect skin tightening and wrinkle reduction. Stephen J. FanningPresident and CEO, Thermage, Inc.
I would rate Dr. Zelickson’s clinic 10 stars! Rose Sinay
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What Is A Port
A baby’s skin is normally pretty much the same colour all over. But with a port-wine stain the baby has a patch of skin which looks different to their usual skin colour. It is usually a pink or pale purple patch on one side of their scalp, neck or face.
That’s why they’re called ‘port-wine’: because port is usually dark red.
How Would A Doctor Diagnose A Port
There is no particular test for a port-wine stain.
- The diagnosis is made on the appearance of a newborn’s skin.
- A biopsy is not normally necessary.
- A port-wine stain should not be confused with a ‘salmon patch’ or ‘stork mark’ that almost half of babies have, on the back of their neck in the midline. This fades over about a year and is entirely harmless.
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A Port Wine Stain Birthmark: How It Affects Your Appearance
A port wine stain is a birthmark caused by the overdevelopment of blood vessels underneath the skin.
The change in the blood vessels is caused by a genetic mutation which occurs before a child is born, and will remain for the rest of a person’s life though the severity of them differs between people.
Port wine stains begin as a flat red or purple mark and, over time, can become more raised, bulkier and darker in color.
They can occur anywhere on the body but 67 per cent of them appear on a person’s head or neck.
Around three in every 1,000 babies has a port wine stain and they are more common in girls than in boys, though the reason for this is not known.
Treatment usually involves laser treatment to remove some of the dark color from the mark, or camouflaging the discoloring using a special type of make-up.
Source: Great Ormond Street Hospital
Reagan has even started her own clothing brand, Hello Port Wine Stain, where she designs clothes around her birthmark and runs a support page on Instagram for others with port wine stains.
Reagan has gained support fast, with her own quickly progressing to nearly 13,000 followers, and her dedicated support page is also on the rise. She has also grown her community of over 330k followers on TikTok.
‘My birthmark is a vascular malformation otherwise known as a port wine stain. Named after the red wine, port wine stain birthmarks are known for their reddish hue and unique ‘stain’ appearance across the body,’ she said.
What Problems Can Happen
For most kids, port-wine stains are no big deal theyre just part of who they are. And some port-wine stains are barely noticeable, especially when theyre located somewhere other than the face.
But port-wine stains often get darker and can sometimes become disfiguring and embarrassing for children. Port-wine stains can make kids feel self-conscious, particularly during the already challenging preteen and teen years, when kids are often more interested in blending in than standing out.
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