PORTWINE STAINS

What is it?

A port wine stain is a red or purple birthmark. Port wine stains are present at birth and grow with the child. They do not improve with time. They can occur on any part of the skin surface but cause most concern when they affect the face. They are also called naevus flammeus.

Port wine stains are flat and pink but as people get older the blood vessels in port wine stains may become bigger and blood flows through them more slowly. At this stage, they look more purple than pink. Later, in adult life, port wine stains often develop bumpy areas which can make applying cosmetic camouflage difficult. Occasionally bleeding can occur in the bumpy areas if they are scratched.

Facial port wine stains can occasionally affect they eye or other underlying organs and in certain cases further investigation is necessary. If it occurs on an arm or leg, it is usual to check that the growth of the limb is normal.

Port wine stains cause a lot of misery because they occur so often in visible areas important for body image, such as the face. A lot can be done to reduce the psychological impact including treatments discussed below, camouflage and advice from patient support groups.

Who gets it?

Port wine stains affect one out of every 500 babies and develop because the blood vessels in the affected skin lack small nerve fibres which are necessary to narrow them. The result of this is that the affected blood vessels are wide open with increased blood flow through the involved skin. This results in a permanent blush - port wine stain.

What is the treatment?

Treatment with the pulsed dye laser helps most patients although it may not clear the port wine stain completely. It is available in a few specialised centres in the UK. Port wine stains in older children can be treated under a local anaesthetic, often using an anaesthetic cream. Young children and those having very extensive areas treated especially around the eyes, need to have their laser therapy under a general anaesthetic or sedation.

Laser treatments lightens 90% or more of port wine stains in children. Depending on the size and site of the birthmark, up to 10 treatment sessions may be required at intervals of 8 weeks or so. Port wine stains on limbs respond less well than those on the face.

Cosmetic or camouflage creams are often very helpful.