Port wine stains are birthmarks that appear as flat, discolored patches on the skin at birth. They do not disappear or fade naturally over time. While permanent without intervention, modern treatments can significantly lighten their appearance.
Understanding Port Wine Stains
Port wine stains are classified as vascular birthmarks or capillary malformations. They arise from an abnormal formation of tiny blood vessels, specifically capillaries, located just beneath the skin’s surface. These capillaries are abnormally dilated or permanently wider than normal, allowing blood to collect in them, which gives the birthmark its characteristic pink, red, or purplish color. They grow proportionally with the child and do not fade naturally because the blood vessels remain expanded. In most instances, these birthmarks are not inherited.
Treatment Approaches
Pulsed Dye Laser (PDL) therapy is the primary treatment for port wine stains. This laser targets the hemoglobin within the red blood cells found in the dilated capillaries. The absorbed laser light converts to heat, causing the abnormal blood vessels to selectively collapse and be destroyed, largely sparing the surrounding skin. Multiple treatment sessions are typically necessary to achieve optimal results, with each session usually lasting only a few minutes and performed during an outpatient visit. Less common or adjunctive treatments for port wine stains can include intense pulsed light (IPL) or surgical excision for any thickened lesions that may develop.
Expected Outcomes of Treatment
While laser treatment can lead to significant fading of a port wine stain, complete disappearance is uncommon, and effectiveness is influenced by factors including the birthmark’s size, location, depth, skin type, and age at treatment. After laser therapy, temporary side effects like bruising, swelling, and redness are common, usually resolving within 7 to 10 days. Less frequent are temporary changes in skin pigmentation, which typically fade over several weeks to months. Scarring is rare with PDL therapy. Individual results vary, and some patients may require ongoing maintenance treatments to preserve fading.
Why Early Intervention Matters
Starting treatment for port wine stains early, ideally during infancy, often leads to more favorable cosmetic results as younger skin tends to respond better to laser therapy, potentially requiring fewer sessions. If left untreated, port wine stains can darken and thicken over time, developing raised bumps or nodules, which may become more prone to bleeding. In some cases, a port wine stain, particularly on the face around the eye or forehead, may be associated with Sturge-Weber syndrome. This syndrome involves abnormal blood vessel growth in the brain, potentially leading to seizures or glaucoma. Early evaluation by a dermatologist or specialist in vascular anomalies is important for accurate diagnosis and treatment planning.