Port wine stain

Port wine stains, or capillary malformations, are a type of birthmark. At Guy’s and St Thomas’, we specialise in removing port wine stains in adults and children with our expert-led dermatology and children’s plastic surgery treatments. 

What is a port wine stain? 

A port wine stain is a vascular birthmark usually present at birth. Port wine stains tend to occur on the face but can also develop in other body areas. Port wine stains grow and darken over time and do not go away without treatment. You can also have more than one. 

Port wine stains are often harmless and do not cause significant health concerns or problems. However, large, dark and obvious ones may affect your confidence. 

Symptoms of port wine stains 

A port wine stain can be pink, red or purple. It looks like a splotch on the skin with clear borders. 

Port wine stains are most commonly found on the: 

• face  
• neck  
• scalp   

Port wine stains will continue to darken and thicken with age and may start to feel bumpy. They’re also more likely to bleed a lot after an injury due to the affected area’s larger blood vessels.  

Symptoms of port wine stains in children 

Port wine stains in children are usually smooth but will grow as your child grows. When a baby is born with a port wine stain, it can appear pink but will darken over time. 

Girls may be at a higher risk of being born with port wine stains, but experts do not yet understand why. However, port wine stains can also occur in boys.     

What causes port wine stains? 

Port wine stains are a vascular birthmark, which means they have to do with the blood vessels in the skin. We can do nothing to prevent port wine stains from occurring.  

Abnormally formed capillaries (blood vessels under the skin) cause port wine stains to develop. Capillaries can be malformed when the chemical signals in the blood vessels don’t turn off, causing the vessels to grow and stretch. The vessels’ additional blood makes the birthmark appear red. 

Experts believe that a genetic mutation could result in port wine stains, but no one is certain why they develop. 

In very rare cases, Sturge-Weber syndrome can cause port wine stains. The condition affects your brain and causes seizures and eye problems. Typically, the birthmark will have no physical effect on your health.    

Diagnosing port wine stains 

It’s straightforward to diagnose port wine stains with a physical skin examination. Generally, our specialists can diagnose the birthmark at birth or shortly after. 

Sometimes, the consultant will also examine your family history and check for any underlying conditions, such as Sturge-Weber syndrome. However, port wine stains are mostly a cosmetic issue.  

Adult port wine stain treatment 

Although port wine stains do not require treatment, they can affect your confidence and self-esteem. Therefore, we offer effective treatment to minimise the appearance of port wine stains and to remove them. 

Our multidisciplinary team, including interventional radiology, works closely to find the correct treatment for your needs. We’ll ensure you receive personalised treatments and excellent results.  

Pulsed dye laser treatment 

We use innovative laser technology, a pulsed dye laser (PDL), which causes minimal scarring. PDL is the gold standard treatment for port wine stains and doesn’t cause significant scarring or damage to the skin. Other treatments can leave behind scarring, such as surgical excision to remove the birthmark. 

A PDL is a highly concentrated light energy that targets the skin’s blood vessels and shrinks them when applied to port wine stains. The result is a drastically minimised port wine stain. 

Generally, several treatment sessions performed at least 1 month apart are required. When you choose PDL for your port wine stain, you’ll be left with a smooth appearance and minimal scarring. 

PDL treatments can be slightly uncomfortable, but they only last a few minutes. If you feel a lot of discomfort during the procedure, let your consultant know and they can apply a numbing agent up to 1 hour before. 

Recovering from PDL 

Most people can go home soon after their treatment. Initially, your port wine stain will look bruised and this can take up to 2 weeks to fade.  

You must follow the specific aftercare we provide. It includes keeping your port wine stain moisturised to promote healing and wearing a high-factor sunscreen to prevent sun damage to the area.  

Treating port wine stains in children 

At Evelina London Children’s Hospital, we also provide port wine stain treatment for children. We can perform PDL treatment on infants. Because the port wine stain is much smaller and lighter, it’s also easier to treat and requires fewer sessions.  

We can also perform PDL in older children and teenagers. Generally, the older they get, the more sessions they’ll likely need as their port wine stain will be darker and larger. However, we can use a local anaesthetic to make the procedure as comfortable as possible for your child.  

Some younger children may find it a challenge to sit still for PDL treatment. If this happens, we can perform treatment under general anaesthetic so they’ll be asleep throughout. If your child has general anaesthetic, they may need to wait in the hospital for a little longer so we can monitor them during their recovery. However, most children can go home on the same day. 

Our children’s plastic surgeons are committed to your child’s safety and wellbeing. We’ll keep you fully informed of the treatment and what your child should expect, so you can be confident that  our specialists are there for every step of the journey.    

Helping your child recover at home 

Your child’s port wine stain may feel inflamed for the first few days. Ensure your child doesn’t rub or scratch the area, as it can cause irritation and issues with healing, such as infection. 

During recovery, they must have a high-factor sunscreen on their face to prevent sun damage.  

You should help them clean the area by gently washing it as the surgeon instructed. We’ll give you thorough aftercare advice so that you can support your child’s recovery.  

If you have any questions, do not hesitate to contact us.