Understanding the Port-Wine Stain

What Are Port-Wine Stains?

Port wine stains are permanent birthmarks. They can be described or appear as the smooth, flat, pink, reddish, or purple mark on the skin of a newborn that can get darker, raised, or bumpy as the child grows. A port wine stain mostly appears on the face but can also affect other body parts.

This condition is named port-wine stains because it appears like someone spilled or splashed dark red wine on the skin. It is also known as nevus flammeus. It is believed that about 3 out of every 1,000 children are born with this port-wine mark.

Generally, port-wine stains are seen on faces. These dark marks are not harmful and usually do not show signs and symptoms of any major health problem. The biggest worry is whether a port-wine birthmark will upset a child or hamper their self-confidence, especially when a child is a teenager. However, port wine stains mostly get darker and thicker over the period. They also may become more flat and smooth.

What Are the Causes of Port-Wine Stains?

Port-wine stains are mainly caused by an issue in small blood vessels, known as capillaries. Generally, capillaries are small and narrow. But port-wine stains are overly dilated, allowing blood to collect in them. This accumulation of blood gives port wine stains a distinctive color. Port-wine stains may become bigger or change their shape when capillaries become larger or bigger.

Port-wine stains on the scalp, forehead, or around the eyes may be a symptom of Sturge-Weber syndrome. This condition occurs when there are unusual blood vessels in the skin and the brain's surface, affecting blood flow to the brain.

When port-wine stains are present on the arms or legs, they may also be a symptom of Klippel-Trenaunay syndrome. In this condition, they usually appear on just one limb.

Klippel-Trenaunay is a rare genetic condition that causes changes in the blood vessels of the affected leg or arm. These changes can cause the bone or muscle of that limb to grow longer or wider than usual.

What Does a Port-Wine Stain Look Like?

A port wine stain is a red-purplish stain on the skin. It has clear borders around the birthmark.

Port-wine birthmarks can occur anywhere on the body, but most commonly on the:

• Face.

• Neck.

• Scalp.

In children, port wine stains are smooth. The birthmark grows as a child grows, but it stays in proportion. Port wine stains may get thicker and darker over time and feel like pebbles beneath the skin. They also may look more like a blood clot or a bruise that is formed after an injury, which can be difficult to control.

How to Diagnose Port-Wine Stains?

By looking at a child's skin, doctors can sometimes tell if it is a port-wine stain. Port-wine stains are harmless birthmarks and do not cause problems or pain. Rarely does it show any sign of other medical-related problems.

For example, the port-wine stains on or near the eye or forehead will be examined by the doctor. They may be associated with a rare neurological disorder called Sturge-Weber syndrome, leading to problems like delay in development, seizures, and learning disabilities. Stains on the eyelids can also result in glaucoma, which means increased pressure inside the eye that can affect vision and cause blindness.

Doctors may indicate some tests such as eye or imaging tests like an X-ray, computed tomography scan, or magnetic resonance imaging to rule out another associated problem. For example, if a kid develops a port wine stain anywhere on the body, a specialist must examine it and plan the treatment accordingly.

Is Port-Wine Stain Harmful?

Port wine stains are harmless and do not lead to any medical problems or pain. Birthmarks can be embarrassing for many children and teenagers, especially when they are large, dark, and located on the face. This can affect self-esteem and socialization.

It is observed that port wine stains occur in patients with Klippel-Trenaunay syndrome or Sturge-Weber syndrome or people born with one of these syndromes have abnormally developed blood vessels in other body parts and should be evaluated for serious complications.

If a port wine stain becomes larger, darker, and raised over the period of life, it can be a sign of other medical-related issues. For example, the stain can bleed more easily than other skin area when it gets injured. Also, some patients with port wine stains around their eyes may have a higher risk for glaucoma.

How Port-Wine Stains Are Treated?

Some port-wine stains are tiny and difficult to find. But some can be upsetting for kids, especially if they are large, dark, or on the face. And any birthmark affects a child's self-confidence, no matter how small or light the stain might be.

Lasers can make many port-wine stains much lighter, especially when the birthmark is on the head or neck, and can be considered the best treatment option. Doctors like dermatologists or plastic surgeons usually give several treatments with a "pulsed-dye" laser. The laser is highly concentrated light energy that targets the pigmentation in the stain and fades it. Multiple treatments can make the birthmark quite lighter. The longer a patient has had the stain, it becomes really difficult to treat it successfully.

Laser treatment can be uncomfortable. Patients usually get anesthetics such as an injection shot, spray, or ointment during the treatment. For young children and infants, general anesthesia is indicated to help them sleep or relax during the procedure. These treatments are very simple and short and take less than ten minutes. After treatment, the area may get irritated and inflamed and feel like a bad sunburn. However, it will get back to normal in a week. If needed, multiple treatments can be done as often as every six to eight weeks.

Doctors sometimes use another type of laser or surgery for port-wine stains when they get bumpy, thick, or raised. Port-wine stains can sometimes also develop grape-like growth of small blood capillaries called vascular blebs. Generally, these do not cause concern, but they often bleed and may need removal.

Some people previously chose other treatments, like freezing, tattooing, and even radiation. But these are not as effective or safe as laser therapy. Laser surgery is the only recommended treatment that works on port-wine stains with less risk of damaging or scarring the skin. Laser treatments may sometimes make the pigmentation darker than normal, but this is usually just temporary.

It is important to note that laser treatments may not eliminate the birthmark completely. However, the birthmark may come back and need to be retreated.

Conclusion

The doctor can check the birthmark regularly and inform the patient of any problems. A port-wine stain, especially when it's large or on the face, might affect a kid's self-confidence. Ask the doctor about the treatment modalities. Laser treatments may help make port-wine stains smaller and lighter.