There are so many different skin issues that can occur at any time, and some of them can be hard to identify. Some problems change over time, while others remain constant, but dealing with any kind of skin problem can feel like an uphill battle, especially if the problem is one that is getting worse, or one that concerns your child. If you have been trying to get information on birthmarks, then you may have come across the term “port wine stain.” This is a specific type of birthmark that can have negative aesthetic consequences over time.
A port wine stain is a specific type of birthmark that is named after its appearance: a patch of darker pink or red skin that resembles a wine stain. Port wine stains can be located anywhere on the body, but they tend to be common on the face, neck, and scalp, unfortunate locations for cosmetic reasons. Children are often fine with their birthmarks when they are young, but can easily become ashamed by them as time goes on.
What Is the Cause? Who Gets Port Wine Stains?
Port wine stains are rare—only about 3 in 1,000 babies are born with this type of birthmark. They are a type of vascular birthmark, meaning they are caused by the dilation of blood vessels beneath the skin. It is believed that port wine stains are caused by a lack of nerve fibers, which control the blood vessels and help keep them narrow. Without sufficient quantities of these, the vessels expand, causing the pink, red, or purple-red pigment to show beneath the skin. This seems to be controlled by a random change to a specific gene after conception. Because this mutation is random, anyone can be born with a port wine stain, and it is not possible to prevent the problem.
Will They Get Worse?
Unfortunately, port wine stains often worsen with age. Babies’ port wine stains are usually flat and light pink, relatively benign in nature. However, if the problem is not treated, adults may end up having thick, pebbly birthmarks that are deep red or purple in color. Depending on the location, this change can be very embarrassing, or even disfiguring. Port wine stains are also very rarely associated with serious disorders, such as Sturge-Weber syndrome, a neurological condition.
Can They Be Removed?
There are treatments available for port wine stains, and they can often significantly reduce the appearance of birthmarks, though not remove them completely. Pulsed dye laser treatments are highly effective and minimally invasive, often requiring no anesthesia at all, and performed in short procedures. Most patients need more than one treatment, and these sessions are usually spaced 8-12 weeks apart, in order to give the results time to become apparent. Once satisfactory fading has occurred, patients may need touch-ups every 18-24 months if new vessels form.
Some skin preparation is necessary, and patients must not tan prior to treatment. The procedure takes under ten minutes to complete in most cases. If desired, a topical anesthetic is applied before the laser is used to treat the vessels.
Redness and swelling will occur following treatment, and may persist for a few days. For the first 48 hours, ice packs should be used at two hour intervals to help with the swelling. Purple pigmentation may appear temporarily, but will fade over the few weeks following each treatment. It is important that patients protect the skin from the sun diligently and avoid tanning for 6 months following the most recent treatment.
Is Treatment Safe for Children?
When it comes to children, it is usually a good idea to be cautious about cosmetic treatments. However, in some cases, it is beneficial to start treatment early. This is often true for port wine stains. More advanced birthmarks are more difficult to treat, so it is a good idea to consider pulsed dye treatments while the marks are still fairly mild. The only difference in the treatment process for children is that a mild anesthesia may be appropriate to make the procedure more comfortable. Whether or not to pursue treatment for a child is entirely personal and different for each family. However, it is a good option for some, and should be taken into consideration, as fading the birthmark early can help prevent teasing that could occur once the child has started school.
Sometimes, port wine stains look similar to other types of vascular birthmarks that fade within the first few years of life and do not require treatment. A plastic surgeon can help you determine whether treatment is necessary, and decide if your child is a good candidate for pulsed dye treatments.
Talking to an Expert
Whether you are interested in treatment for yourself or your child, you do not want to trust your treatment to anyone but a highly trained and experienced expert. Your best bet is to speak with a board certified facial plastic surgeon like Dr. Stuart Bentkover. Dr. Bentkover has been a laser expert for decades, and has a proven track record of providing excellent results to patients with port wine stains. If you would like to discuss your or your child’s birthmark with Dr. Bentkover, call Bentkover Facial Plastic Surgery and Laser Center to schedule an appointment at his Worcester (508-363-6500) or Stoneham (617-247-0033) office today.