Common Childhood Conditions
Port Wine Stains
What does a port wine stain (PWS) look like?
A PWS begins as flat, pink to dark red areas of skin. They got this name because their color and appearance looks like a splash of purple or red port wine on the skin. They usually follow nerves on the face or arms and legs.
A PWS on the eyelid or forehead sometimes signal a similar stain in the brain called Sturge-Weber syndrome.
What causes a PWS and who gets them?
PWSs affect one out of every 500 babies. They develop because the blood vessels in the affected skin lack small nerve fibers, which are necessary to narrow the vessels.
The result is that the affected blood vessels are wide open with increased blood flow through the skin in that area.
Will a PWS change?
As your child gets older the blood vessels in port wine stains may become bigger. At this stage, they look more purple than pink.
In adults, PWSs often develop bumpy areas. Occasionally, bleeding can occur in the bumpy areas if they are scratched.
I think I've seen a PWS on my child. What should I do now?
Someone who is familiar with capillary malformation or port wine stains should see your child to determine whether treatment is necessary.
This is especially important because PWSs on the upper face can involve the brain and brain coverings.
How will Seattle Children's diagnose a PWS?
The diagnosis is usually made by the physical appearance. Your child's doctors will consider whether there is a possibility of an associated syndrome, including:
- Arteriovenous malformation
- Beckwith-Weidemann syndrome
- Bonnet-Bechaume-Blanc syndrome
- Cobb syndrome
- Klippel-Trenaunay-Weber syndrome
- Proteus syndrome
- Sturge-Weber syndrome
If underlying vascular lesions or other abnormalities are suspected, further imaging is done.
How will Seattle Children's treat a PWS?
PWSs can be simply watched for changes or treated with a series of laser treatments.
The most common laser used for PWSs is the pulse dye laser. This laser will lighten the color of the port wine stain with several treatments.
If the skin becomes thickened and nodular or bumpy, surgery or a different type of laser may be used to improve the appearance of the PWS.