Port-wine Stain Birthmarks – Everything You Need to Know

July 16, 2020

Woman with port wine stain birthmark on cheek

About 10% of babies are born with one or more birthmarks.  A port-wine stain birthmark is a unique type of birthmark that has a noticeable red appearance which can sometimes be upsetting for new parents. Port-wine stain birthmarks can look a little frightening for new parents, and so it’s no surprise that many parents call to have it checked on. There’s bad news and good news for people with port-wine stains. The bad news is that they won’t clear up on their own. The good news is that they are treatable. This blog walks you through everything you need to know about port-wine stains and the available treatments for this type of birthmark.

What Are Port-wine Stain Birthmarks?

Port-wine stains are capillary malformations, which are the most common type of vascular birthmark. An older term for this type of birthmark is nevus flammeus. They became known as port-wine stains due to the dark red or maroon coloring that resembles red wine spilled on the skin. Port-wine stains may appear on any part of the body, but they are most commonly on the face and neck.  In infants, a port-wine stain typically looks like a smooth red patch.  The birthmark may be very small or cover a large area of skin.  Both men and women and all racial groups are impacted by port-wine stain birthmarks. There is no way to prevent the development of this type of birthmark, and they aren’t caused by anything that the expecting mother does or doesn’t do.

Unlike other birthmarks that tend to fade over time, port-wine stains will not go away on their own. In most cases, port-wine stain birthmarks look lighter pink or red on newborns, but they will get darker as the child grows up. In addition to getting darker, port-wine stains may also become thicker and change in texture as the child grows up. What begins as a smooth mark that is flush with the skin, may become thicker, grainy, or feel as though there are small pebbles beneath the skin.

While port-wine stains don’t clear up on their own, most children and adults with port-wine stain birthmarks do not have a whole-body disorder associated with serious health problems.  However, over time a port-wine stain can become thickened and nodular and bleed.  Depending on the location of the port-wine stain it can affect the eyes and/or teeth, lips, and mouth, as well as the underlying facial bones.    Some people experience serious medical and cosmetic issues when port-wine stains develop on the face. In addition to potential medical issues, untreated large port-wine stain birthmarks on the face can make children feel self-conscious, and if the texture becomes thickened as they age, these birthmarks can have a profound impact on self-confidence during adolescence. Luckily, port-wine stains can be treated, and early intervention for young children in many cases will significantly improve the appearance of these birthmarks.

Are Port-wine Stains Different from Other Types of Birthmarks?

Most birthmarks are areas of the skin that are different in color or texture but are not necessarily related to anything going on beneath the skin’s surface. This is not the case for port-wine stains. Port-wine stains are actually a type of capillary malformation that occurs during the first few weeks of gestation where capillaries do not form correctly and become dilated. When untreated, blood vessels within the port-wine stain can become even more dilated, which may lead to excessive bleeding following even mild injuries. These injuries can lead to the risk of infection and other health concerns. In addition to the risk of bleeding and infection, port-wine stains may also cause hypertrophy. This is the development of thickened skin and underlying tissues that can change the shape and appearance of the part of the body where the birthmark is located, which is particularly problematic for people with port-wine stains on their faces.

Can Port-wine Stains be Treated?

Because of the cosmetic concerns and potential health issues related to port-wine stains, your dermatologist may recommend treatment to remove these birthmarks or diminish their appearance. A port-wine stain can be treated using a vascular-targeting laser. Several treatments are typically required followed by intermittent maintenance treatments. The expected outcome varies among patients. In some patients, the condition responds very well and it is difficult to see the birthmark.  For some, it is significantly improved but still visible, and in others, it merely prevents worsening of the condition. The age of the patient at the time of treatment as well as the severity and location of the port-wine stain both factor into the treatment result.

Laser therapy for port-wine stains can begin when your child is still an infant, and early treatment has proven effective in preventing many of the more serious health effects like bleeding and disfigurement as well as improving appearance. The treatment itself can be a little uncomfortable, so we’ll numb the area to keep the process pain free. Depending on the child’s age and response to treatment, we may also recommend other types of sedation to ensure they can safely and comfortably receive laser birthmark treatments.

How Much Downtime Should I Expect After Port-wine Stain Treatment?

Following port-wine stain treatment with a vascular-targeting laser, there is no ‘downtime.’ However, the treated area usually appears darkly bruised afterward, which will resolve within two weeks.

When Should I Consider Port-wine Stain Treatment for My Child?

When it comes to treating port-wine stains, there is no such thing as, ‘too early.’ Dermatologists have treated multiple patients in the first weeks of life. Earlier treatment is beneficial to the patient both in treatment outcomes and in preventing worsening of the condition as the child grows.

Does Insurance Cover Port-wine Stain Removal?

This varies by insurance, but laser treatment for port-wine stain birthmarks is typically covered by insurers. A U.S. Dermatology Partners team member will be happy to walk you through insurance coverage and financing options.

What Risk Factors Would Prevent Port-wine Stain Treatment?

Our providers emphasize safety when it comes to laser therapy removal. There are no risk factors that would prevent treatment, but the patient has to be able to undergo the procedure safely, i.e. sit still, use protective eyewear, tolerate the mild discomfort associated with the laser, etc. There have been children from birth up to about one year in the office. After this point, treatment can become more difficult, so we may need to provide laser therapy at a hospital under general anesthesia. Once children are old enough to understand their port-wine stain treatment, in-office laser therapy is generally possible again.

Schedule an Appointment at U.S. Dermatology Partners

When you’re ready to find out more about port-wine stain treatment, you can schedule an appointment with a U.S. Dermatology Partners provider. You can schedule an appointment in any of our dermatology office locations, using our simple online scheduling request form. Once you’ve completed the form, one of our knowledgeable team members will reach out to you to confirm your appointment date and time.

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