A port-wine stain is a type of birthmark
that got its name because it looks like maroon wine was spilled or splashed on the
skin. Though they often start out looking pink at birth, port-wine stains tend to
become darker (usually reddish-purple or dark red) as kids grow.
Port-wine stains won't go away on their own, but they can be treated.
Laser therapies can make many port-wine stains much less noticeable.
What Are the Signs of Port-Wine Stains?
Port-wine stains (also known as nevus flammeus) can be anywhere
on the body but most commonly are found on the face, neck, scalp, arms, or legs. They
can be any size, and usually grow in proportion with a child.
They often change in texture over time, too — early on, they're smooth and
flat but they may thicken and feel like pebbles under the skin during adulthood.
What Problems Can Happen?
For most kids, port-wine stains are no big deal — they're just part of who
they are. And some port-wine stains are barely noticeable, especially when they're
located somewhere other than the face.
But port-wine stains often get darker and can sometimes become disfiguring and
embarrassing for children. Port-wine stains (especially on the face) can make kids
feel self-conscious, particularly during the already challenging preteen and teen
years, when kids are often more interested in blending in than standing out.
Can Port-Wine Stains Be Prevented?
Port-wine stains can't be prevented — and they're not caused
by anything a mother did during pregnancy.
How Are Port-Wine Stains Diagnosed?
Your doctor can sometimes tell if it's a port-wine stain by looking at your child's
skin. Port-wine stains are usually nothing more than a harmless birthmark that doesn't
cause any problems or pain. However, they're sometimes (though very rarely) a sign
of other medical conditions.
For example, port-wine stains on or near the eye or on the forehead need to be
monitored. That's because they may be associated with a sort of "stain on the brain"
(a very uncommon neurological disorder called Sturge-Weber syndrome
that causes problems like seizures, developmental delays, and learning disabilities).
Stains on the eyelids may also lead to glaucoma — increased
pressure inside the eye that can affect vision and lead to blindness if left untreated.
If there's a concern about the location of a port-wine stain or symptoms, your
doctor may order tests (such as eye tests or imaging tests like an X-ray, CT scan,
or MRI) to see what's going on and rule out another problem. If your child has a birthmark
anywhere on the body it's important for your doctor examine it to see what
type it is and what kind of monitoring and treatment it needs, if any.
How Are Port-Wine Stains Treated?
Although some port-wine stains are small and hard to see, some can be really upsetting
for kids, especially if they're large, dark, or on the face. And any birthmark can
take a toll on a child's self-confidence, no matter how large or small the mark might
The good news is that lasers (highly concentrated light energy) can make many port-wine
stains much lighter, especially when the birthmark is on the head or neck. Dermatologists
or plastic surgeons usually give several treatments with a "pulsed-dye" laser.
Laser treatment is often started in infancy when the stain and the blood vessels
are smaller and the birthmark is much easier to treat. But that doesn't mean laser
treatments can't help older kids or teens, too — it's just that the longer someone
has had the stain, the harder it might be to successfully treat it.
Laser treatment can be uncomfortable. During the treatment, kids can usually be
given an anesthetic (given as a shot, spray, or ointment to numb the area). Young
kids may also be given general anesthesia to help them sleep or relax during the procedure.
After treatment, the area might be swollen and bruised at first, but it will be back
to normal in 7 to 10 days.
For port-wine stains that have become bumpy, thick, or raised, doctors sometimes
need to use another type of laser or surgery. Port-wine stains can also develop grape-like
growths of small blood vessels called vascular blebs — these
aren't usually cause for concern, but they often bleed and may need to be removed.
In the past some people have chosen other treatments, too (like freezing, tattooing,
even radiation). But these aren't as effective — or as safe —
as laser therapy. Laser surgery is the only treatment that works on port-wine
stains with less risk of damaging or scarring the skin. Sometimes, though, laser treatments
may make the pigmentation lighter or darker than normal, although this usually is
And laser treatments may not get rid of the birthmark entirely (though some birthmarks
disappear completely after treatment). Plus, over time the birthmark may come back
and need to be retreated.
For a small number of kids, laser treatment might not work at all. Every child's
port-wine stain is different, so whether or not the treatment works well will be different
for each child, too.
Port-wine stains can get very dry sometimes, so it's important to use a moisturizer.
Also be sure to call the doctor if your child's port-wine stain ever bleeds, hurts,
itches, or becomes infected. Like any injury where there's bleeding, make sure to
clean the wound with soap and water and use a gauze bandage to place firm pressure
on the area until the bleeding stops. If the bleeding doesn't stop, call
If your child's port-wine stain has been treated with laser surgery, avoid rubbing
or scratching the area, and gently cleanse it with lukewarm water. Your doctor may
prescribe an ointment to aid in healing and help prevent infection.
As with any birthmark, port-wine stains (especially on the face) can make kids
feel different and insecure about how they look. If it's clearly visible, people might
ask questions or stare, which can be hurtful for both you and your child. Even at
a young age, kids watch how their parents respond to these situations and take cues
about how to cope with others' reactions.
Practice responses so your child will feel more prepared when asked about it. It
can help to have a simple, calm explanation ready like, "It's just a birthmark. I
was born with it."
Talking simply and openly about a birthmark with kids makes them more likely to
accept it as just another part of themselves — like their height or eye color.
It's also important, emotionally, for kids to be around supportive family and friends
who treat them like everyone else.
Of course, it's still natural for kids to want to do whatever they can to minimize
a birthmark. In addition to laser treatments, special cover-up makeup can hide the
stain and make living with it a little easier.
Still, kids with port-wine stains (or any birthmark, really) need to know that
they're no different from other kids. If anything, it may help to tell your child
that kids born with a port-wine stain are unique in a good way — it's
a special, colorful part of themselves that few other people have.