Port wine stains and birthmarks

Port wine Stains At A Glance

  • Best Results2-10 treatments
  • Treatment Recovery4 - 8 days
  • Procedure Time5 to 20 minutes
  • Skin SpecialistDavin Lim, Dermatologist
  • Duration of ResultsVariable - years
  • AnaestheticNumbing, Sedation, Gas
  • Back to WorkVariable
  • Cost$$ Medicare rebate applies

Port wine stains and birthmarks

The most common birthmark I treat are port wine stains. I also work in with vascular surgeons to treat AV malformations and other vascular lesions. Red birthmarks respond much better to laser compared to brown birthmarks. Over 90% of red birthmarks can be markedly reduced with laser treatment.

FactsFacts on port wine stains & birthmarks

  • Red birth marks such as port wine stains and vascular lesions are much easier to treat than brown or pigmented birth marks
  • Port wine stains are one of the most common birth marks and occurs in 2-4 out of 1000 births.
  • Red birth marks include stork marks, port wine stains & mixed vascular lesions
  • Brown birthmarks include café au lait macules, moles at birth and Becker’s or late onset naevi
  • Most red birth marks such as port wine stains are only present just below the skin, however some stains around the eye area maybe associated with ocular problems
  • Laser treatment of RED birthmarks can improve lesions by up to 90%
  • Depending on the age, size, thickness and location of the birthmark, 5- 10 treatments maybe needed
  • I use the VBeam Vascular lesion in most cases of red birthmarks
  • Brown birthmarks are much harder to treat, and usually a Q Switch laser is needed- results are not as predictable as treating red birthmarks

What different types of birthmarks are there?

Port Wine Stains

The classification of birthmarks can be complicated, however, the prognosis and clearance rates can be determined by color. Red birthmarks are much easier to treat compared to brown birthmarks with the exception of CALMS. These birthmarks are the easiest to treat.

Red birthmarks include port-wine stains, stork bite birthmarks, & various marks caused by abnormal blood vessels.

Brown birthmarks include congenital naevi or moles at birth, Becker’s naevi, Café au lait macules, & epidermal naevi. Some of these birthmarks are barely visible at birth but increase in the teenage years.

Identifying the type of birthmark you have is extremely important because this determines the success rate of laser treatment.

What are port wine stains?

Port wine stains

PWS or port wine stains are classed as vascular birthmarks, and are made up of thousands of tiny capillaries lying in different depths of the skin. They can be slightly pink when early, but a deep purple in adult age. PWS most commonly occur in the face and neck area, but can affect any part of the body including the limbs.

PWS do not cause symptoms, but can be psychologically distressing, especially if they occur on the face. These birthmarks should be investigated at birth to rule out any eye involvement. Fortunately the majority of PWS respond very well to V Beam vascular laser. I use both the V Beam Perfecta & the newer V Beam Prima.

How common are port wine stains?

PWS are one the most common vascular birthmarks, affecting 2-4 out of 1000 births in Brisbane. These birthmarks vary in size from a few centimetres, uncommonly they may affect an entire limb.

Can port wine stains affect areas away from the skin?

Yes! PWS surrounding the orbit can affect the eye area. All patients who exhibit this pattern of birthmark should be reviewed by an eye doctor. Very large port wine stains on the limbs can give rise to growth changes. Your GP or Paediatrician will discuss the possibility for further investigations and ongoing monitoring.

When can port wines stains be treated?

There is controversy in regards to when is the best time to have port wine stains and other blood vessel lesions treated.  I do believe that the very earliest treatment should be commenced ‘ as soon as possible.’ The best centers in the World, including the Royal Children’s Hospital in Melbourne treat vascular lesion early in life, however they can be treated and improved at any age.

For patients <12 years old, the Children’s Hospital in Brisbane has a laser unit to treat birthmarks in children.

How do lasers treat port wine stains?

Lasers work on the basis of ‘selective thermolysis.’ This means that a specific wavelength is needed to treat blood vessels. Each laser will have an ideal target. In vascular stains such as port wine lesions, the target is haemoglobin, found in blood. Laser targets haemoglobin, and transfers its energy via heat to the vessel walls. This heat destroys the walls, and fades the port wine stain.

Remember, port wine stains and vascular birthmarks lie under your skin. This means that the top layer of your skin must be protected from the laser beam. A very clever trick is to cool the skin’s surface a fraction of a second before the laser is delivered- this is termed Dynamic Cooling Device. This makes treatments more comfortable and safer.

I use 4 different laser and light based machines to treat vascular lesions depending on your skin type, depth of the blood vessels and previous responses. Cutis represents the largest specialist laser center in Queensland – we have the ability and skill level to treat all forms of vascular lesions from port wine stains thru to venous lakes and AV Malformations.

What type of lasers do I use to treat port wine stains?

A vascular laser is the most common laser I use to treat Port wine stains. The type of vascular laser will depend on the thickness of the birthmark, and previous treatment success and or failures. My laser of choice is the 595 V Beam laser, or the newer V Beam Prima as this is considered the Gold Standard for many vascular birthmarks. If the blood vessels are thick or lie deep in the skin I also use a 755 Alex laser or a long pulse 1064 NdYag laser.

Lasers with a special cooling system are best for birthmarks.

Davin’s Viewpoint on port wine stain & birthmark laser treatments

Along with acne scarring, treating birthmarks is one of my favoured laser procedures. It changes people’s lives. Birthmarks are very common, occurring in up to 30% of the population. Some patients don’t even realise they may have a birthmarks as it can be as subtle as a beige mark on the back, or a feint pink ‘Stork Mark’ on the back of the neck. In the other extreme, birthmarks can be very noticeable- especially port wine stains on the face. The good news is that red birthmarks are responsive to lasers in over 90% of cases, the flip side is that many treatments maybe needed- anywhere between 2-15. I usually space treatments at least 6 weeks apart. As mentioned not all birthmarks can be treated with laser- reds tend to do better than browns, and birthmarks on the face tend to do better than those on the trunks and limbs. An accurate assessment and diagnosis is the very first step.

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