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FAQ Port Wine Stain

Port Wine Stain specific
Are Port Wine Stains (PWS)/Port Wine Birthmarks(PWB) present at birth?

Yes all PWS/PWB are present at birth but the color may vary depending on the baby’s skin tone.

Are PWS/PWB progressive lesions?

Yes. It is reported that around 75% of all PWS/PWB will get darker and thicker over time.

Are PWS/PWB the most common vascular birthmark

No. They are the second most common vascular birthmark, after the Infantile Hemangioma

Are there common sites of predilection for PWS/PWB of the head and neck area

Yes there are. See figure.

Locatie wijnvlekken op het hoofd

Can a laser clear all PWS/PWB vessels, or just the ones it can reach?

The laser can only destroy the excess blood in the vessels that it can reach. Currently there is no laser that can reach all capillary vessels.

Additionally, some vessels have a very fast blood flow that the laser cannot reach. The current lasers only penetrate 1-2 mm. Capillaries (which make up a PWS/PWB0 vary in depth and size. You cannot target something that you cannot reach in depth, or catch in speed. However in some cases complete clinical clearance can occur.

Can a PWS/PWB be associated with other syndromes such as SWS, KTS, etc?

Yes. A PWS/PWNB can be a clinical indicator of an underlying syndrome.

Can a PWS/PWB get lighter or darker based on the temperature?

A PWS/PWB can appear darker or lighter based on temperature.

Do most PWS/PWB occur in the head and neck area?

Yes. Approximately 67% occur in the head and neck area.

Do PWS/PWB occur equally in men and women?

Yes. It occurs equally across sexes.

Does a PWS/PWB ever go away naturally?

It is extremely rare for a PWS/PWB to resolve spontaneously without treatment. They are persistent lesions.

Does skin tone have to do anything with a PWS/PWB?

Skin tone does not matter as far as the pathology of the PWS/PWB. However it will ‘appear’ different based on skin tone. A PWS/PWB will appear more prominent on a lighter-skinned individual as compared to a darker-skinned individual.

Has the PWS/PWB been associated with the GNAQ gene mutation?

Yes. There is an association.

How does laser therapy lighten a PWS/PWB?

Light from the laser goes into the skin and is absorbed by blood in the abnormal vessels. During this process, heat is generated, which coagulates the abnormal vessels.

Is a PWS/PWB a cosmetic condition?

A PWS/PWB is not a cosmetic condition. The entire affected area is abnormal; both the visible portion of the PWS/PWB and the area beneath the birthmark.

Is it important to treat a PWS/PWB early?

Yes. A PWS/PWB treated in infancy can result in maximum clearance if treated with frequent sessions. Regardless, treatment is still highly effective at any age and similar clearance can occur at any age.

Other than laser therapy, are there any additional treatment options?

Laser treatment (therapy) is the current standard for treating a PWS/PWB. There are other ‘light or energy sources’ which may also be helpful in treating these lesions.

What are the different names for a PWS/PWB

Port Wine Stains/Port Wine Birthmarks are also known as a capillary malformation, nevus flammeus, or a firemark.

What do you call the spots/dots that appear following a laser treatment?

The spots that appear following a laser treatment are called ‘purpura’.

What is PWS/PWB and what is the purpose of treating it with a laser?

A PWS/PWB consists of malformed capillary blood vessels, which is why the medical term is ‘capillary vascular malformation’. The purpose of treating a PWS/PWB is to reduce the excess blood in the malformed vessels. ‘Treatment’ does not mean ‘removal’.

What is the best treatment for a PWS/PWB?

Laser therapy is the gold standard for treating a PWS/PWB. Along with reducing malformed vessels, it also preserves the integrity of the skin by preventing tissue thickening or cobbling.

What is the prevalence of babies born with a PWS/PWB?

1 in 300 babies are born with a PWS/PWB.

What is the prevalence of babies born with a PWS/PWB?

1 in 300 babies are born with a PWS/PWB.

Will all PWS/PWB get thicker or develop cobbling?

The majority of untreated PWS/PWB will thicken and produce cobbling over time. For this reason it is not cosmetic to treat a PWS/PWB. Laser treatment focuses on preventing thickening, spontaneous bleeding and cobbling.

Will treating the PWS/PWB remove the condition?

Treating a PWS/PWB with a laser will not remove the condition. However, treatment of some PWS/PWB can achieve 100% clearance so that the stain is not visible to the naked eye.