Laser Port Wine Stain Birthmark Removal

Port wine stains, also known as capillary malformations, are vascular birthmarks that appear as pink, red, or purple patches on the skin. They are sometimes called “stork bites” on infants and, if they appear light colored, can sometimes disappear in early childhood. Port wine stains often develop at birth and can grow in proportion with the individual. While they are usually harmless, some individuals may seek their removal due to cosmetic concerns or potential psychological impact. Pulsed dye laser treatment is the leading option for effectively reducing or eliminating port wine stains, offering hope for those seeking to lessen their appearance.

Understanding Port Wine Stains

Port wine stains occur due to abnormal blood vessel formation near the skin’s surface. They persist throughout a person’s life and, in some cases, may become raised or thickened over time. These birthmarks can appear anywhere on the body but are most commonly found on the face, neck, arms, and legs.
Apart from their visible physical presence, port wine stains can have emotional effects, especially when located on prominent areas of the face or other visible body parts. This psychological impact can lead individuals to seek treatment options to reduce their appearance.

Laser Treatment: How it Works

Laser therapy is the best and most common option for treating port wine stains. The procedure involves using concentrated beams of light (from a pulsed dye laser like the Vbeam) to target and destroy the blood vessels causing discoloration. The light energy is absorbed by the blood vessels, heating and causing them to coagulate and collapse without damaging the surrounding skin. In this type of laser treatment, the small blood vessels that form the birthmark burst, causing a dark bruise on the skin. The maroon or purplish bruises resolve within 7-10 days and the blood vessels that burst during treatment recede below the skin’s surface to reveal a more natural tone.

Although several types of lasers can be used for treating port wine stains, pulsed dye lasers (PDL) are among the most utilized. These lasers emit specific wavelengths of light that are absorbed by the hemoglobin in the blood vessels, effectively treating the targeted area. The leading pulsed dye laser for the removal of red birthmarks is the Candela Vbeam. It has been the gold standard in port wine removal since 2000 and uses a wavelength of 585 – 590 nanometers, which is highly absorbed by the blood vessels we are targeting.

The Treatment Process

Before beginning laser treatment, a thorough evaluation by a dermatologist or a specialist trained in pulsed dye laser treatment is necessary. The evaluation helps determine the size, location, depth, and color of the birthmark and the patient’s overall health. While pulsed dye lasers are an excellent option for port wine birthmark removal, not all candidates are appropriate for treatment.

During the procedure, you may be given a topical anesthetic to minimize discomfort. Protective eyewear is also worn to shield the eyes from the laser’s light. The laser device is then passed over the affected area, emitting short bursts of light. The sensation is often described as a snapping or stinging feeling, but discomfort is typically manageable. The outcome is a darkening of the skin color to a deep maroon (like a dark red wine) from the bruising caused during treatment.

The duration of the treatment depends on the size and location of the port wine stain, but most marks can be treated in 10 – 30 minutes. Multiple sessions are typically required for optimal results and the number of treatments is based on the density and depth of the blood vessels that make up the birthmark. Treatments are usually undertaken between 4-6 weeks apart to allow the skin to heal completely between treatments.

Post-Treatment Care and Results

Following laser treatment, redness and bruising will occur in the treated area. These are normal side effects that are part of the removal process and typically resolve in 7-10 days. It is crucial to follow our post-treatment care instructions to aid in the healing process and reduce the risk of complications. Although limited after care is required, sometimes aquaphor or a thin layer of Vaseline will be used to sooth the skin if any flaking or crusting of the area occurs during the healing process.

The results of laser treatment for port wine stains vary from person to person. While some individuals experience significant fading or complete removal of the birthmark, others may see a reduction in color intensity or size. Multiple sessions are often necessary to achieve optimal outcomes, and complete removal may not always be possible.

Considerations and Risks

While laser treatment for port wine stains is safe and effective, there are potential risks and considerations. These include:

• Skin Changes: Some individuals may experience temporary or permanent changes in skin texture, such as lightening or darkening of the treated area. Both are rare and temporary hyperpigmentation (darkening) of the skin is more common if a patient is Hispanic or Asian.
• Incomplete Removal: Complete removal of the birthmark may not always be achievable, and multiple sessions may be necessary for noticeable results. This is especially true for birthmarks off the face. Port wine birthmarks on the limbs are harder to removal than those on the neck and face.
• Cost and Time: Multiple sessions are often required, and the cost varies based on the size and time required to treat the area. Insurance coverage for port wine stain removal vaires but at our office we do not bill insurance.

Conclusion

Since around the year 2000, pulsed dye laser treatment has revolutionized the management of port wine stains, offering individuals a viable option to reduce the appearance of or remove these birthmarks completely. While the treatment may not guarantee complete removal, it significantly improves the appearance of port wine stains, boosting self-confidence and enhancing quality of life for many individuals.

Before opting for laser therapy, it is crucial to consult with a qualified healthcare professional to discuss expectations, potential risks, and the best course of action. With proper evaluation, treatment, and post-care, laser therapy can be a transformative solution for those seeking to diminish the visibility of port wine stains.