In those precious moments of first bonding as a new mother cradles her infant, she instinctively examines for imperfections. Sadly, she sometimes finds them. Birthmarks are common – and particularly familiar is the port-wine stain.
Port-wine stains are vascular abnormalities; they vary from pink to purple, are usually unilateral, and most frequently involve the forehead, face and frontal region of the body. Their presence may signify other syndromes in which internal organs, in addition to the skin, are involved. When located on the forehead, eyelids or both sides of the face, they may indicate a propensity towards glaucoma or seizures. Occasionally, a dermatologist may advise that another specialist (ophthalmologist or neurologist) is required.
Port-wine stains are defined as those birthmarks, that part of the nevus flammeus family, that persist into adulthood. They rarely disappear without intervention. Usually they grow as the child grows, tending to darken to purple with age.
Thickening can occur and nodular areas within the field of the port-wine stain can develop in some affected people, creating a large unsightly appearance. A port-wine stain may develop little blood vessel growths which should be removed because they bleed easily, and it is difficult to stop the bleeding. There may even be gradual enlargement of tissues surrounding the port-wine stain which should be monitored.
Early intervention is important – not only for medical reasons, but because there can also be psychological impairment. As the child grows and begins to interact with others, he/she becomes keenly aware of the blemish. When other children react, sometimes with cruelty, the patient feels like a victim and can suffer feelings of inadequacy. Such episodes promote social anxiety and set the stage for emotional problems. Parents and family are equally affected and often treat the child differently.
Another reason for early intervention is that many researchers believe early treatment may prohibit the proliferation of the port-wine stain, particularly preventing thickening, nodules or blood vessel growth.
Laser technology has been available for a decade, but now, with new techniques and equipment, we can treat port-wine stains 10 times faster and with better results. It’s a safe and simple way to achieve 75-90 percent lightening over several treatments for most patients. FDA-approved and available only at selected dermatologic laser centers, this outpatient procedure is giving children, in the words of many mothers, “a new lease on life.”
Today, with a new form of topical anesthesia that minimizes or alleviates pain, and a trend toward early treatment (even in infants as young as two weeks), it is now possible to free children from the serious physical and psychological effects of port-wine stains. While early treatment is recommended, these birthmarks can also be treated successfully years later, even in adulthood.