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The port-wine stain is another type of vascular birthmark that occurs in 3 in 1,000 infants. It is sometimes called a nevus flammeus, but it should not be confused with a hemangioma.
Port-wine stains appear at birth. They are flat, pink, red or have a purplish discoloration. Port-wine stains are found most often on the face, neck, arms or legs. They can be any size. Unlike hemangiomas, port-wine stains grow proportionately as the child grows. Over time, port-wine stains may become thick and develop small bumps or ridges. Port-wine stains do not go away by themselves, and are permanent.
Complications of Port-Wine Stains
Port-wine stains, especially those on the face, can have emotional, social, and economic complications. Port-wine stains on the forehead, eyelids or both sides of the face, can be associated with glaucoma and/or seizures. Glaucoma is an increased pressure within the eye that left untreated, can cause blindness. These complications occur in less than half of those with port-wine stains of the forehead and eyelids. All infants with a port-wine stain in those areas should have a thorough eye examination, and if indicated, further brain imaging.
Occasionally, there may be very gradual enlargement of tissues surrounding a port-wine stain, especially if it is affecting an arm or leg. All children with large port-wine stains should be followed for any growth problems.
With time, port-wine stains can develop small blood vessel growths called vascular blebs. These can bleed easily and may be removed.
Treatment of Port-Wine Stains
The use of cover-up makeup has been a common treatment for port-wine stains. Your doctor can provide you with more information about products that are made to cover up birthmarks.
Various methods have been tried in the past to remove port-wine stains, but none have worked well. New types of vascular lasers show the best results with the least amount of risk and side effects. Laser treatment of port-wine stains is FDA-approved and available at many dermatologists' offices around the country. Laser surgery is performed on an outpatient basis. Several treatments are usually required, given at two month intervals. In a small number of patients, lasers can totally clear up the port-wine stain. They lighten the vascular mark 50-90 percent. For reasons that are not fully understood, a small number of patients will not respond well to laser therapy.
There are several risks of laser therapy. An increase or decrease in skin color can occur, leaving patchy tanning or whitening of the skin. In most cases this is not permanent. Swelling, crusting or minor bleeding can occur. This is unusual and can be treated easily. Permanent scarring occurs in a small number of patients. Laser therapy is uncomfortable, but not extremely painful, as there is no cutting of the skin. General anesthesia is not required for most adults but topical anesthesia (applying a cream) is available. However, general anesthesia is often necessary for toddlers and young children. If putting the child to sleep is required, there are some risks to general anesthesia as well as higher costs.
Most vascular birthmarks go away without treatment or can be treated effectively. Through research, dermatologists are learning more about the causes and treatments of all types of vascular birthmarks.
We apologize for not showing any photos here for ethical reasons. You may refer to the following website for before and after photos: www.aad.org
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