Port-Wine Stains: What Are They and Can They Be Treated?


Medically Reviewed by Dr. Lee Hwee Chyen

MBBS MRCP (UK) FAMS (Dermatology)

Port-Wine Stains: What Are They and Can They Be Treated?

Port-wine stains are a type of birthmark present at birth and typically only affect a small percentage of newborns. Named after their colour, which resembles the rich hue of port wine, these stains are usually flat and can vary in size.

Characteristics of Port-Wine Stains

Port-wine stains are characterized by a patch of discoloration, which appears reddish to purplish in hue. The size of port-wine stains varies from small patches to large areas covering significant parts of the body.

Port-wine stains are most commonly found on the face, neck, scalp, arms, or legs. They are not contagious and are usually harmless. They are usually present at birth and may appear more prominent with time.

They usually occur on their own, but less commonly, they may be associated with some syndromes.

Possible Complications of Port-Wine Stains

While port-wine stains are generally a harmless birthmark, in some rare cases, they may lead to complications or indicate other medical conditions.

Thickening of Skin and Nodules

Over time, untreated port-wine stains can become raised and develop a rough texture. Small lumps known as nodules may form within the stain due to overgrowths of blood vessels. These nodules can cause discomfort and affect the aesthetic appearance of the skin.

In some cases, these nodules require surgical intervention for removal. The risk of nodule formation and skin thickening increases with age.

Skin Degradation

Prolonged dilation of blood vessels leads to increased blood flow and pressure in the affected vessels, potentially causing damage to the skin over time.

The skin loses its integrity, elasticity, and normal texture. Thinning of the skin may also occur, making it more susceptible to injury and slower to heal. The skin may become more fragile and prone to bleeding.

Sturge-Weber Syndrome

Sturge-Weber Syndrome is a rare neurological disorder involving neurological and eye abnormalities.

The presence of a facial port-wine stain, especially if it covers the eyelid or forehead, can increase the risk of developing Sturge-Weber syndrome due to the abnormal growth of blood vessels in the brain and eyes. This can lead to seizures, developmental delays and glaucoma.


Caused by increased pressure in the eye which can damage the optic nerve and lead to vision loss.

In individuals with port-wine stains in the ophthalmic region (nearest to the eyes), the risk of developing glaucoma is elevated due to the increased potential of abnormal blood vessel development in the eye, similar to those causing port-wine stains on the skin.

Bleeding and Ulceration

These issues arise when the skin overlying a port-wine stain becomes fragile and more prone to injury. In such cases, minor trauma to the area can lead to bleeding.

The constant dilation and stress on the blood vessels within the stain can cause the overlying skin to break down, forming an ulcer. These ulcers can be painful, may become infected, and often require medical treatment to heal.

Diagnosing Port-Wine Stains

Port-Wine stains have a characteristic appearance that usually makes them distinguishable from other types of skin discolouration, allowing for visual diagnosis of port-wine stains by dermatologists.

A dermatologist conducts a visual examination, assessing the size, location, and colour of the stain. There may be consideration of family history, although hereditary patterns are rare.

Treatment Options for Port-Wine Stains

Laser Therapy

Laser therapy is the most common and effective treatment for port-wine stains. Pulsed dye lasers emit a specific wavelength of light absorbed by oxyhemoglobin in the blood vessels. This absorption causes the blood vessels to heat up and collapse without damaging the surrounding skin, leading to the lightening or complete removal of port-wine stains across multiple sessions.

Consider undergoing laser therapy as early as possible as younger patients often respond better to laser treatment. Multiple sessions are required to achieve the desired clinical response. Older lesions are usually more resistant with time and treatment of a port wine stain in an adult is usually more challenging than that of a young child.

Risks of Laser Therapy

Laser therapy, while effective for treating port-wine stains, can pose risks such as:

  • Skin Irritation: Common side effects of laser treatment include redness, swelling, and bruising in the treated area. These symptoms are typically temporary but can cause discomfort.
  • Scarring: Scarring or changes in skin texture may occur following laser therapy.
  • Incomplete Removal: Laser therapy may not completely remove a port-wine stain. In some cases, the stain may only be lightened, or it may recur after initially successful treatment.
  • Pigmentation Changes: Hyperpigmentation (darkening of the skin) or hypopigmentation (lightening of the skin) may occur in the treated area. These pigmentation changes can be temporary or permanent.
  • Eye Damage: If the port-wine stain is near the eyes, the intense light may damage the eyes.

Benefits of Laser Therapy Treatment

Laser therapy for port-wine stains often results in a reduction in their visibility and improved skin texture. Laser therapy can also enhance an individual’s self-esteem and psychological well-being.

  1. Cosmetic Improvement: Laser therapy typically makes port-wine stains less noticeable. Over time, it can lighten the colour of the stain, blending it more with the surrounding skin tone.
  2. Skin Texture Enhancement: In cases where port-wine stains have thickened or developed a rough texture, laser treatment can help smooth and normalize the skin surface. It also reduces any associated discomfort or irritation.
  3. Psychological and Emotional Benefits: Laser therapy can enhance an individual’s self-esteem and confidence, especially for individuals with stains on visible areas like the face.
  4. Long-term Skin Health: Early and consistent laser treatment can prevent the port-wine stain from darkening and becoming more prominent with age, maintaining the skin’s health and appearance over the long term.

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