Port Wine Stain in Infants

If you notice a pink or red stained birthmark, like the colour of wine on a baby, it is known as a port-wine stain. On seeing such a mark, parents tend to get apprehensive and make different assumptions about the same. The common questions that run through the minds of the parents are – “Are these stains harmful or harmless?”, “Could they be treated or not?”…well, worry not! All your fears will be put to rest once you read this.

What is a Port Wine Stain?

Port-wine stains in newborns (nevus flammeus) is a discolouration of skin to pink, red, or purple colour. These marks are present from birth or occur shortly after birth. Port-wine stains are explained as vascular which cannot be left unattended always, as sometimes they may indicate some severe disorders. Unlike other birthmarks, port-wine stains will not disappear or fade with time. By the time your kids turn teenage, these stains may thicken and form a lump causing social trauma.

How Common Is a Port Wine Stain?

About 0.3% of babies may have a port-wine stain, which means 1 in every 300 newborns may have a port-wine stain. This ratio concludes that port-wine stain is a common occurrence. They are not slanted towards any gender and may occur in boys and girls proportionally.

Where Can it Occur?

A port-wine stain can occur on any area of the skin. Mostly they occur on the face and neck. Commonly it is detected on one side of the body or appear irregular. It is rare that it would occur on both sides of the body or is spread evenly across the body.

What Does Port-Wine Stain Birthmark Look Like?

A port-wine stain looks very similar to vascular birthmarks, also known as strawberry marks. Initially, this mark is thin. It may be negligibly small that its presence is unknown. However, with time, these marks may grow in proportion to the child’s growth. And when they develop as a lump, young adults become conscious of their personalities.

Causes of Port Wine Stains in Infants

Science explains these unique marks as mutation of genes. When there is an absence of nerve supply to blood vessels, it causes blood to collect in the accumulated area. This results in the pink or reddish stains visible on the skin. This is also known as dilation due to the reduction of vascular tone.

Signs and Symptoms of Wine Stains

Port-wine stains on babies are mostly red or pink, but there are other symptom and signs too that spread awareness of its uniqueness:

• These stains are not hereditary or may not occur because of some pregnancy development or a certain deficiency. A port-wine stain is random and is present by birth.
• In rare cases, the stains may occur at any time of age.
• In the initial stages, the stains are pink or red in colour but over time the colour deepens.
• They do not irritate the skin.

Diagnosis

Port-wine stains are usually harmless, but sometimes they may be considered as birthmarks connected to other vascular disorders. If your child has a port-wine stain, you might want to take him to an ophthalmologist or a neurologist.

Potential Risks and Complications

The risk and complications associated with port-wine stains are rare. In fact, there is no risk if the stain is small. However, there are a few risks related to port-wine stains which are mentioned below:

• Growth: One of the greatest complications is the lump like appearance. This leads to an increase in the emotional and social trauma that the individual may already be under.
• Blood flow: When the skin thickens, it can bleed easily. Hence, it’s important to get it treated as it is just in the initial stage.
• Eyes and brain abnormalities: 65% of the stain marks are usually on the face and neck. Even if the stain is on the face, only 1 in 100 babies is affected with associated problems.
• Spine abnormalities and varicose veins: A port-wine stain has been linked to issues such as unusual hair growth on the back of the spine and neural tube defects.

Long-term Problems Associated with Port Wine Stain

Port-wine stains on babies rarely lead to long-term problems. These complications arise only in certain individuals without any provocation or trigger. Following are the long-term problems associated with a port-wine stain that children may develop:

• Glaucoma: This is a condition that increases pressure in the eye leading to blindness. 10% of facial port-wine stains lead to glaucoma. Children with a stain around the eye are at risk and need to be examined by an ophthalmologist to avoid severity. It can be treated by eye drops or by an operation if need be. Observe a child’s eyes for abnormalities such as swelling, large pupils.
• Sturge-Weber syndrome: This is a neurological disorder that indicates its presence through , development delays, and cognitive problems. It is advised to not neglect a port-wine stain around the eye, forehead, or scalp.

Treatment for Port Wine Stain Birthmark

Port-wine stain removal for infants should be done at the earliest. Getting it examined within a year of birth will have better chances of successful treatment than waiting to treat at a later stage. The condition of port-wine only progresses with age and, early treatment detects any further disorders like Sturge-Weber syndrome and glaucoma on time. For treating a port-wine stain, these two treatments are recommended:

• Laser Treatment: This treatment is known to treat stains effectively. The laser light converts to heat rays and penetrates red colour (haemoglobin) of the accumulated blood vessels. Depending on the intensity of the stain, the doctor will recommend the number of sessions for the treatment. The treatment may prove successful or a failure depending on the reaction of the skin to the treatment.
• Cosmetic Camouflage: As the word suggests, it is camouflaging the stain with the help of cosmetics such as concealers and skin-covering makeup. These are used if one does not wish to opt for laser treatment or when the treatment is not successful.

Home Care

To avoid , use a moisturizer regularly, apply Vaseline if moisturizer does not help. If the part of skin where you have a port-wine stain is infected, bleeding, or injured, it is advised to clean the area properly and soon visit a doctor.

Follow Up

After the laser treatment, it is important to take care of the skin where your child had a port-wine stain. Adopt these ways to avoid complications later:

• Do a check-up after every session. The skin will be sensitive and sore, proper relief and care should be taken to comfort the child.
• Application of petroleum jelly on the area has been helpful to shield and heal the area post laser treatment.
• Call the doctor if the wound on the stain does not heal or requires immediate attention due to post-laser problems.

Prevention

There is no way to prevent port-wine stains. However, if treated at the earliest, many associated problems will be prevented.

Things to Remember

• Port-wine stains are birthmarks that cannot be prevented.
• They are known to occur after birth at any age.
• Port-wine stains do not spread from one to the other.
• They are not painful. However, if the pain is experienced, immediate medical attention is required.
• It is best to treat a port-wine stain in newborns at the earliest.
• It is just a unique mark and you need to let your children know this. The more they become comfortable with this uniqueness, the lesser problems they will have with it.

The most significant treatment is the parent’s positive attitude towards the stain. This will give a child the confidence to thrive the harshness of the outside world.