Let’s be honest. Babies don’t arrive fresh from the womb looking like the Gerber baby, especially after natural birth. They have vernix; they may be puffy if you had an epidural; they have bruises and rashes and hair in all the wrong places. And what about birth marks?
Does your baby have a port wine stain? Is it cause for concern?
Read on for the types of birthmarks babies typically have, causes of port wine stains, and available treatment options.
Birthmark, stork bite, or port wine stain? How to tell the difference.
Many babies are born with birthmarks of some kind. Whether or not you should be concerned depends on what kind of birthmark your baby has. There are three main types of birthmarks to consider:
The most common type of birthmarks are called pigmented birthmarks, and generally present as brown spots that can appear just about anywhere on the body. They are caused by clusters of pigment cells and are not a cause for concern.
Vascular birthmarks include stork bites, salmon patches, and angel kisses. These are often seen on the back of the neck (stork bites), or on the face or head (angel kisses). They are extremely common; as many as 50% of newborns have some type of stork bite. (source)
These types of vascular birthmarks are caused by a cluster of blood vessels and are usually pink or light red in color and flat. They usually fade or go away as a child ages.
Port wine stains
Port wine stains are a different type of vascular birthmark, which may require treatment. We’ll discuss port wine stains in more detail below.
What is a port wine stain?
Port wine stains (also called nevus flammeus) are a type of capillary (small blood vessel) malformation. They’re characterized by pink or red patches of discolored skin, frequently on the neck or head, but can also be found on other areas of the body.
Port wine stains typically start off lightly colored at birth, but tend to get darker (if left untreated) as baby grows. This vascular birthmark can range from barely noticeable, to more prominent, in which case, there may be treatment options you might want to consider, which we’ll discuss below.
If your baby has a port wine stain, odds are, it can be treated, and it will not develop into a more serious problem.
Port wine stains are fairly common, and you’ve probably seen them before, whether on friends or family, or even a few celebrities:
- Tina Turner has a port wine stain on her right upper arm.
- Billy Corgan of The Smashing Pumpkins has an extensive purple birthmark covering his left hand and arm.
- Mikhail Gorbachev, former Soviet statesman, has a prominent port wine stain on his head, which extends to his forehead.
Port wine stain birthmarks: what’s normal?
- Color: port wine stains may be a red, pink, or purple birthmark.
- Size: they can vary from just millimeters in size, to several inches in diameter. A port wine stain birthmark will grow larger as baby grows.
- Location: port wine stains are commonly seen on the face, head, and neck, though they can also be found on the torso, arms, or legs.
- Development: the vast majority of port wine stains are present at birth.
- Treatment: a port wine stain birthmark will not go away on its own.
Are port wine stains hereditary?
The prevalence of capillary malformations is 0.3%, or about one in 300, and they can be hereditary. (source)
It is not uncommon for parents with port wine stains to also have children born with port wine stains, as there is a genetic mutation responsible for the condition.
What causes a port wine stain?
Scientists have recently found that a single genetic mutation may be responsible for port wine stains, and the related but less common condition Sturge-Weber syndrome. (source)
Emerging research has shown that genes can be “switched” on or off, based on a number of factors, including lifestyle choices as well as predetermined susceptibilities. When it comes to port wine stains, scientists have discovered that following conception, a gene responsible for capillary malformations essentially gets “stuck” in the “on” position. (source)
When this genetic mutation occurs, blood vessels do not develop normally. These malformed blood vessels can then cause a port wine stain birthmark, affecting the blood vessels nearest to the skin, usually on the neck or head. When the blood vessels become permanently dilated, they cause a permanent “blush” appearance on the affected area.
Imagine a cluster of tiny blood vessels coming together, overcrowded, just under the surface of the skin. Instead of allowing blood to flow freely, delivering oxygen and nutrients to other tissues in the body, the capillaries dilate, causing increased blood flow near the surface of the skin. This is the cause of a port wine stain.
What are treatment options for my child’s port wine stain?
While each child’s port wine stain is different and treatment will depend on many factors, you do have some options.
Port wine stains are most commonly treated with pulsed dye lasers.
Much like laser treatment of spider veins, treating port wine stains with a laser causes selective destruction of the problematic vessels. Following the procedure, the surrounding capillaries will rebuild during a healing phase, restructuring for correct blood flow.
Capillaries that are not sufficiently targeted may recover and continue causing problems, which is why multiple treatments are generally necessary. Other types of lasers, like infrared, may be used for dark or resistant lesions. (source)
The laser type and number of treatments, as well as how well the treatment works, can vary based on how dark or large the port wine stain is, as well as where it’s located.
Treatments are relatively quick, out-patient procedures, and include a localized anesthetic, though general anesthesia may be recommended for uncooperative children or those with very large port wine stains.
It’s suggested that treatments occur every 2-4 weeks, until improvement is no longer observed.
The majority of patients will have more than 50% lightening of their [port wine stains.] Suboptimal response remains a significant obstacle observed in 20%–46% of patients, and 14%–40% have been reported to show minimal to no response, for diverse reasons. Multiple treatments are the norm, and most patients require eight to ten treatments or more for optimal results. (source)
Treatment side effects
Keep in mind that port wine stains get darker and larger as a child grows, so it’s suggested that treatment begin in early infancy for the best chance of removal. Treatment may begin as early as several days after birth. (source)
Side effects of laser removal include:
- and scabbing
In cases where hair is present at the site of treatment, bald patches may occur. Scarring is uncommon, but can occur if proper care is not taken to avoid it, so be sure to seek out a qualified medical professional.
Additionally, treatment on port wine stains near the eyes can lead to damage to the inner eye workings, particularly if the mark is very dark and requires more intensive laser techniques.
Suggested treatment for scabbing or blistering following removal is petroleum jelly and moist bandages, though we suggest a more natural jelly like this.
If you’re interested in port wine stain removal, here’s what you need to know:
- the earlier you seek treatment, the better
- not all port wine stains will respond to treatment
- be sure to find a qualified medical provider to perform the removal
Port wine stain complications
Because normal blood flow at the site of port wine stains is restricted, other complications can occur.
Port wine stain birthmarks can be related to a rare but more serious condition called Sturge-Weber syndrome, a neurological condition associated with seizures, learning disabilities, one-sided weakness or paralysis, and glaucoma.
A child born with a port-wine stain on the face has approximately a 6% chance of having the Sturge-Weber syndrome, and this risk increases to 26% when the port wine stain is located in the distribution of the ophthalmic branch of the trigeminal nerve. (source)
Sound complicated? Let’s break it down.
The trigeminal nerve is a cranial nerve located within the brain. Its primary responsibility is transmitting sensations from the face to the brain. The ophthalmic branch of the trigeminal nerve performs sensory functions, including those related to the eyes and sinuses. (source)
When a port wine stain is located anywhere on the face, neck, or head, the risk of complications is increased due to the possibility of impeding the function of important nerves.
Other complications associated with port wine stains include:
- issues with the eyes or sinuses
- feeding problems or other oral health concerns
- increased skin disorder developments, including lesions and nodules
- a rare disorder called Klippel-Trenaunay syndrome which can cause a malformed limb
Helping kids cope
It’s important to help kids with port wine stains feel comfortable with their birthmark early on. Don’t avoid talking about it, but instead, help your child understand that his port wine stain is just a part of who he is.
As the child gets older (and if the birthmark is in a very visible area), it may even be helpful to practice discussing his unusual birthmark to prepare for uncomfortable conversations with strangers. You can help your child practice explaining his port wine stain as if he were talking with a stranger.
As children age, they may find they prefer to cover up their birthmark with makeup.
How about you?
Does your child have a port wine stain? Did you get treatment for it and just let it be? Share with us in the comments below.