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Port Wine Stain

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What is a Port Wine Stain?

A Port Wine Stain is a collection of abnormally formed blood vessels (capillaries) in the skin, which results in a red mark that may have the color of port wine. Although most Port Wine Stains are present at birth, it has been reported in few cases to develop later in life (‘acquired Port Wine Stain’).

What causes a Port Wine Stain?

The cause of Port Wine Stains is not known. During the development of an affected baby in the mother’s womb, abnormal small blood vessels are formed near the surface of the skin.

Acquired Port Wine Stains may appear without a known cause, as part of an illness or in previously inflamed or injured skin. 

Is a Port Wine Stain hereditary?

Port Wine Stains do not often run in families; however, they are relatively common, affecting about 1 in 300 babies, equally in both sexes. Port Wine Stains are not contagious or cancerous.

What are the symptoms of a Port Wine Stain?

Uncomplicated Port Wine Stains do not usually cause any physical symptoms. However, they can upset the quality of life of the affected individual and their family. Eczema can develop over a Port Wine Stain, which may then be itchy or sore. A Port Wine Stain may rarely be part of more widespread abnormalities, some of which are listed below: 

  • A Port Wine Stain in the skin around the eye may be associated with increased pressure in the eye (glaucoma). A referral to an eye specialist may be required.
  • Rarely a Port Wine Stain on the upper face can be linked to abnormalities within the brain (called Sturge-Weber-Syndrome). Neurology specialists can investigate this condition with scans. 
  • A Port Wine Stain on the central back overlying the spine can be linked to an underlying spine defect called spina bifida (Latin for ‘split spine’).
  • Klippel-Trenaunay-Syndrome occurs when there is the enlargement of the limb affected by the port-wine stain, which may also develop enlarged deeper varicose-type veins.

How does a Port Wine Stain look like?

Most Port Wine Stains affect the face, but they may involve any area of the skin. The appearance of a Port Wine Stain tends to change during life. A flat faint red, purple or pink mark is usually seen at birth, which may become temporarily darker when the baby cries, has a temperature or is teething.

Although the Port Wine Stain usually does not get larger, it does grow in proportion with the child. Port Wine Stains often turn darker red or purple in adults, and the skin becomes thicker. Lumps can form (a cobblestone-like appearance), which may bleed readily. The lip or nose, if involved, may, in some people, become slightly swollen. 

How is a Port Wine Stain diagnosed?

A dermatologist can diagnose a Port Wine Stain by taking a history of the skin changes and looking at the appearance of the skin.

Can a Port Wine Stain be cured?

Unfortunately, a Port Wine Stain does not go away on its own and usually cannot be cured, although it may become far less noticeable after treatment.

How can a Port Wine Stain be treated?

Various lasers are used to treat Port Wine Stains, and early treatment is possibly more effective, as the baby’s skin is thinner and the Port Wine Stain relatively small. However, even after successful early treatment, the remaining areas of Port Wine Stain may darken again later in life. 

The Pulsed Dye Laser is most commonly used. It emits a beam of special light, which reacts with the red color in blood. Adults do not usually require an anesthetic, apart from cooling the skin. Children may need a general anesthetic.

The treatment causes immediate dark bruising, and the skin is more sensitive to rubbing. Other possible temporary side effects include blistering and crusting. Scarring is rare. A course of laser treatment is usually required, with a few months between repeated treatments.

Treatment aims to make the Port Wine Stain paler, as it is often not possible to make it fade completely. If the Port Wine Stain has developed bleeding areas, these can be successfully treated by laser. In addition to the Pulsed Dye Laser, several other lasers and light-based treatments are in use, and research is on-going for treatment-resistant Port Wine Stains.

Skin Camouflage can be very useful. Camouflage is a type of unique, water-resistant make-up that matched the color of the normal skin. You can get a prescription for a special kind of camouflage make-up that covers up the birthmark.