Port Wine Stains - Diagnosis & Treatment

Port wine stains (PWS) are common vascular birthmarks that present as pink to red discoloration on the skin. 

Port wine stains remain constant throughout life and grow proportionally with the child’s growth.

Over time, these areas tend to darken and thicken, often with the development of nodules and the potential for anatomic disfigurement.

We certainly agree with our colleagues and the Vascular Birthmark Foundation’s (www.birthmark.org) statement:

“PWS should not be considered a cosmetic problem but a disease with potentially devastating psychological and physical complications.”

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What Causes Port Wine Stains?

The cause of this birthmark is not well understood. PWS can present on any area of the body, with the majority located on the face.

Depending upon the size and location (e.g., large, facial, near the eye), PWS may be associated with complications. Your provider will discuss this topic with your family if applicable.

Treatment for Port Wine Stains

Pulsed dye laser therapy is considered the gold standard for the treatment of PWS. The wavelength of this laser specifically targets the hemoglobin within the vessels, causing selective vessel damage. Purple areas (i.e., purpura) are expected for 7-14 days following the procedure and can often be a good indicator of adequate laser energy for effectiveness.

To minimize the potential for increased thickness and nodular development of the PWS, we recommend that you begin laser therapy early to achieve the best results. In our practice, we usually start laser therapy at approximately 6 months of age, especially if general anesthesia is required, as this is considered a safe age for elective anesthesia.

Several treatments are typically required for maximal improvement and are typically spaced out every 3 months (often dictated by insurance companies).

Currently, our PWS patients are treated at the Cook Northeast Center (Hurst) with the Candela (V-Beam) pulsed dye laser equipped with a cryogen or dynamic cooling device (DCD). With the addition of the DCD, the risks of scarring or skin changes are significantly decreased.

Dr. Ghali has over 20 years of experience treating PWS with pulsed dye laser therapy. He works closely with pediatric radiologists, plastic surgeons, ophthalmologists, and other pediatric specialists in the management of PWS and other related vascular birthmarks.

Take a look below for photos of what a difference the appropriate treatment for port wine stains can make!