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Uncovering Birthmarks

The causes and treatment for port wine stains


by Dr. Kaycee Reyes

“Look at her face,” you’d overhear one whisper to the other when they see an unusual, pink, splotchy mark on one side of the person’s face, resembling spilled wine. Yes, this is called a port wine stain. You may have seen it once or a few times among classmates or friends when you were growing up, because three in every 1,000 babies have it, regardless of gender or race. Some call it a beauty mark, a strawberry mark, or a birthmark, but no one knows why it appears on some, when it appears, or if these markings pose any health risks. Birthmark

Port wine stains (PWS), also called nevus flammeus, are a cluster of damaged and wide blood vessels. This irregularity is what makes it red and visible on the skin. Most cases of PWS are present since birth. There is no known cause for PWS. It cannot be prevented as well. PWS usually appears on the face, but may also appear on other parts of the body and range in size and visibility. It usually grows as the child grows, the texture may thicken and grow lumpy as the person ages, and the color may also gets darker through the years, from pink to wine. There are rare cases where PWS may be acquired not at birth but due to another condition, a neurological condition called Sturge-Weber syndrome (where PWS appears on the forehead or upper area of the face), or a spinal condition called spina bifida (with the PWS appearing at the back near the spinal column). Apart from these rare conditions, PWS is not cancerous, contagious, or hereditary, but it may disrupt the individual’s quality of life, especially for children who get stared at or talked about by their peers because of how they look.

Physicians can determine port wine stains by examining the skin and knowing the patient’s medical history. It should be differentiated from other red marks common in children like infantile hemangioma because of the variation in natural history and management.  Unfortunately, port wine stains have no cure and do not fade over time, but there are ways to conceal it. One is by topical skin camouflage, or a special cream that can conceal the PWS. Others try hiding it with a tattoo. Some opt for surgery. But a more effective and less painful way to treat PWS is through lasers. These may require more than a few sessions but it can result in permanently faded birthmarks. The pulsed-dye laser, usually the one used for PWS, is a beam of light that converts to heat, destroying the blood vessels on targeted areas. This type of laser treatment is safe, even on children. In fact, it is ideal to have your PWS removed while the color is still light and the size is still small.

Port wine stains, while not treated should be kept moisturized as it could be drier than other areas of the skin. If the PWS itches, bleeds, or is painful, visit a doctor right away. Children with PWS need extra support and reassurance from family and friends that they are okay, in spite of their skin condition. With the success of pulsed-dye laser treatments, those with PWS, young or old, must look into it to finally eliminate the markings once and for all.

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