Kids Health Info

Port Wine Stains

  • Port wine stains (also known as capillary malformations) are birthmarks made of tiny blood vessels. They are quite common and happen in three out of 1000 babies. Some port wine stains are small, others can be quite large.

    Port wine stains can be found anywhere on the body, but most often appear on the face, neck, arms, legs and scalp. They can make children feel self conscious or lose their self confidence.

    Normally there are no other related problems with port wine stains. If the birthmark is on the forehead or cheek, there is a rare risk of epilepsy or eye problems. If the birthmark is on the body or limbs, that side may grow to be a different size. 

    Causes

    The cause of port wine stains is not fully understood. It is believed they are due to a problem with the nerves that control how much the capillaries widen in the area where the port wine stain mark is. When the capillaries keep expanding, they allow a larger amount of blood to go into blood vessels and this causes a stain to form under the skin.

    Signs and symptoms

    • A child is born with port wine stains. They are not caused by anything a mother did during pregnancy.
    • They appear as a flat, red to blue area. The colour often becomes a darker, purple colour with age. They may become thick and lumpy after many years.
    • They vary in size from small to whole body regions. They do not grow in size but will grow in proportion as your child grows. 

    Treatment

    Some children with port wine stain marks on their face may develop self-esteem problems. If you decide to get treatment for your child, it should start by the time your child is six months old. This allows time for a good deal of improvement before your child starts school. 

    Some port wine stains can become very dry. It is important to apply moisturising cream to them.

    Laser therapy

    Laser therapy is currently the best treatment available for port wine stains. Laser is a high-energy light source. This type of laser only targets blood vessels. It destroys the blood vessels that make up the birthmark without injuring the skin on top. Many treatment sessions are usually needed and it is not always successful.

    However, for every 100 port wine stains treated with laser treatment:

    • 80 will get at least 50 per cent lighter
    • 10 will disappear completely
    • 10 will have no change

    The feeling of the laser on the skin is a bit like being flicked with a rubber band. Adults can usually tolerate this quite well for small areas. An anaesthetic may be needed in children, especially those with large areas to be treated.

    The possible side-effects of laser include:

    • ulceration and scarring (less than one in 100);
    • infection;
    • changes in skin colour.

    Your child will have significant bruising, swelling and some discomfort afterwards. A general anaesthetic has risks, which you should discuss with an anaesthetist.

    Care at home

    After having laser, simple pain relief such as icepacks and paracetamol (e.g. Panadol) may be needed.  If blistering or scabbing occurs, apply vaseline and contact your doctor for antibiotic ointment such as bactroban to treat the affected area. Also, call your doctor if the blistering and scabbing starts to bleed.

    There are no specific instructions for routine care of a port wine stain. They may be covered with camouflaging make-up, for example Dermablend, which you can buy in department stores.

    Follow up

    • Your doctor will arrange a follow up appointment.
    • If blistering or weeping occurs apply Vaseline as first aid. Then contact:
      The Royal Children's Hospital Laser Department
      T: (03) 9345 6441 or call RCH switchboard on (03) 9345 5522 and ask for the Dermatology Registrar.

    Key points to remember about port wine stains

    • Port wine stains are permanent birthmarks.
    • They can be treated to reduce their size or change their appearance.
    • Port wine stains rarely lead to more serious problems.
    • They are not contagious - they cannot be spread from one person to another.
    • They are not genetic - they cannot be passed from one generation to the next.
    • If you choose to have more children, there is no increased risk of your next child having a similar birthmark.

    Other sources of information


    The content for this fact sheet has been contributed to by the following RCH departments: Dermatology, Surgery, General Paediatrics. First published January 2004. Updated November 2010.

Disclaimer
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts.