Port Wine Stains
Port wine stains are common birthmarks seen in 2-3 in a thousand births. The use of vascular laser treatment is the most promising method of port wine stain removal, with 90% of patients achieving lesion fading. Cutis Clinic treats port wine stains with our VBeam vascular laser – the gold standard for lesion fading.
Port wine stains are common red birthmarks that occur in 0.2-0.3% of births
Port wine stains around the eye area may be associated with visual disorders
Port wine stains on the limbs can be associated with limb length changes
Laser treatment of port wine stains are effective in 90% of cases
Depending on the thickness of a port wine stain, different laser types may be required
Port wine stains can be treated in all age groups, including infants, teenagers and adults
Cutis Clinic dermatologists use the VBeam laser as our port wine stain treatment of choice
What Can Be Achieved With Vascular Lasers?
Dr. Davin Lim states that – “Laser treatment can have a profound effect on port wine stains, especially when treated early. The number of laser treatments needed to fade and/or remove a port wine stain is dependent on many factors including the location of the birthmark, age of patient, size of port wine stain and skin type. A consultation with your laser dermatologist will inform you as to the possibilities.”
What Are Port Wine Stains?
Port wine stains are capillary malformations made up of thousands of abnormal patterns of blood vessels that lie just below the surface of the skin. Port wine stains can occur on any part of the body but most commonly affect the face, scalp and limbs. Early stains appear as pinkish areas; however, over time they may get darker. Lumpy areas (known as nodules) may also form as time passes and stains often thicken as one grows older.
When Should Port Wine Stains Be Treated?
The ideal time for port wine treatment is as soon as practically possible. Many leading centers around the globe, including the Royal Children’s Hospital in Melbourne, begin treatment when babies are only a few weeks old; however, port wine stains can be treated at any age.
At Cutis Clinic, treatment, we treat port wine stains from the age of 12 years old. This is because we do not provide for general anesthesia. Babies and young children with port wine stains living in Queensland usually attend Lady Cilento Children’s Hospital for laser treatment.
What Treatments Are Available for Port Wine Stains?
Laser treatment is the only way to remove or fade port wine stains. The right choice of laser type depend upon the age of the stain and the depth of the blood vessels. Cutis Clinic owns three lasers that have all been proven to successfully treat port wine stains; 90% of affected patients are treated with our VBeam vascular laser, the gold standard for port wine stains treatment due to its dynamic cooling system that protects the upper layers of the skin. Deeper port wine stains (older stains or lumpy stains) are treated with our Nd:YAG laser which uses a wavelength that penetrates into the deeper layers of the skin.
Lasers work by a process called selective photothermolysis, transferring selective laser light waves to blood vessels that heat-seals the vessels of red or vascular birthmarks.
Regardless of the type of laser used, multiple treatment sessions (4-8 on average) are necessary to fade port wine stains. Some patients may require annual top-up treatments.
What Type of Laser Is Used To Treat Port Wine Stains?
Port wine stains are best treated with a vascular laser. The type of laser used will depend on factors such as port wine stain thickness, age and skin type.
As already mentioned, Cutis Clinic owns three lasers suited to the treatment of port wine stains. These are the popular, gold standard VBeam (595nm), the deep penetrating Nd-Yag (1064nm) and the GentleLASE (755nm). All devices are considered suitable for different degrees of port wine stains. Consult with a Cutis Clinic specialist dermatologist to see which device will produce the best results.
How Are These Laser Treatments Performed At Cutis?
All laser treatments are performed in our comfortable, modern and excellently equipped Cutis Clinic laser suites. On average, treatments take between 2 – 10 minutes to perform depending on the size of the port wine stain. As light sedation may be required for deeper treatments, patients may be monitored for up to an hour following treatment.
How Many Treatments Will I Require?
The number of treatments will vary from person to person. Other factors that influence the number of treatments include the age of the port wine stain, its size and depth, the site and the skin type.
Most port wine stains start to fade after 2 treatments. On average, patients require 4-8 treatments. Stubborn port wine stains on the limbs may require up to 15 treatments.
How Much Improvement Can I Expect From Laser Treatment?
As a rough guide, 90% of patients can expect improvement with laser treatment. The earlier the treatment, the better the clearance rate.
10-20% will experience complete clearance
80% will have at least a 50% improvement with laser
10% will have no response to laser treatment
In all cases, multiple laser treatments are required (6-15) over a course of months to years.
Is The Laser Treatment For Port Wine Stains Painful?
In short, yes. Due to the laser’s high power settings a relatively high degree of pain involved. Children under the age of 12 will usually need a general anesthetic and are therefore referred to the Lady Cilento Children’s Hospital in Brisbane. Older patients are made more comfortable using:
Sedation and skin cooling
Inhaled anesthesia and skin cooling
The in-built dynamic cooling device of the laser protects superficial skin from the beam. In addition, our dermatologists will prescribe pain relief and sedation. This means that the procedure is very well tolerated. You will be advised to to continually apply ice to the treated area following treatment. Panadol is recommended for pain relief over the next 24 hours. Aftercare instructions will be discussed with immediately following laser treatment.
Can IPL Be Used To Treat Port Wine Stains?
IPL or intense pulse light is not the gold standard treatment for port wine stains. IPL is a general treatment for hyperpigmentation, and works for lighter cases rosacea. While not the first choice for port wine stains, IPL can improve the condition if used correctly. The wavelengths used are not specific enough to treat port wine stains, and the power settings of IPL machines are not strong enough. Additionally, Medicare does not recognize IPL as a port wine stain treatment and patients will not receive any reimbursement. In short, IPL can help but it is our last treatment of choice for port wine stains.
What Should I Expect After Laser Treatment?
Laser treatment of a port wine stain is much like minor surgery and the recovery process will continue for a few days to a week.
IMMEDIATELY AFTER LASER TREATMENT
Immediate bruising, swelling and redness is seen almost all patients. The area will feel slightly burned. Following laser treatment, you will be kept in a recovery area with ice packs applied for at least 30 minutes. Ice packs should be applied for 10 – 20 minutes each hour for 4 – 6 hours after laser treatment. This will help to reduce the swelling, pain and bruising.
SEVERAL DAYS LATER
Swelling subsides within 1 – 3 days, as will the pain and redness. Bruising may be visible for an additional 3 – 6 days, depending on the laser power settings and personal factors. Skin peeling may occur after a few days; if this happens, use a simple aqueous moisturizer a few times a day. You should start to heal within 4 – 7 days following treatment.
*Blistering following laser treatment of port wine stains is uncommon; however, if it does occur apply Vaseline to the blistered areas and arrange for a follow-up as soon as possible.
A WEEK OR TWO LATER
Swelling and redness following laser has gone, bruising is barely noticeable, and the skin will start to look and feel normal. Your port wine stain will still be present and in most cases will not look any different prior to laser. It is only a month or two after laser treatment that gradual fading will commence.
A MONTH OR TWO LATER
Most patients notice a degree of fading. The late response is due to the delayed ‘inflammatory cascade’ that shrinks the blood vessels.
What Should I Consider Before Getting This Treatment?
There are several important factors to be considered prior to arranging a consult. These factors should be carefully considered as they are in your best interest.
TIME OFF WORK AND DOWNTIME
When laser treatments are performed for port wine stains, they have to be performed well or not at all. In short, a degree of bruising, swelling and redness will be expected in 100% of patients. Recovery time ranges from 4 to 12 days, depending on the laser setting, area treated and individual patient factors. Your laser dermatologist will be able to give you a much more accurate estimation of ‘downtime’.
This treatment is painful and Cutis Clinic does not provide sedation for children under 12 years of age. Adult and teenage patients can be treated safely with inhalation sedation. In the presence of these prescription medications, the procedure is very well tolerated. Pain management is therefore not an issue for teenage and adult patients.
Costing can be an issue and we will need to take into consideration how many treatments you may need. Medicare will reimburse our patients for port wine stain treatment. Up to 6 treatments are reimbursed per annum and the Medicare Safety Net applies to birthmark treatments, too.
MOTIVATION FOR TREATMENT
Our experienced laser specialists will do their utmost to achieve the best possible results using the most advanced laser technology in the world. We always aim for the best outcome, in this case maximal clearance, while ensuring every treatment is in accordance with stringent safety protocols. As a Cutis patient, you must be able to attend multiple laser sessions as prescribed by your specialist and understand that results may not be seen for several treatments; it may take months or sometimes a year or two to complete treatment.
What Are The Side Effects Of Laser Treatment For Port Wine Stains?
COMMON SIDE EFFECTS
Bruising, swelling, redness and manageable post- laser pain are experienced by all patients.
UNCOMMON SIDE EFFECTS
In less than 2% of patients, ulceration, pigmentation changes (especially in darker skin), infection (via blisters) can occur. Early specialist intervention will reduce permanent consequences of port wine stain laser treatments.
Can Make Up Be Effective In Covering Port Wine Stains?
Absolutely. Make-up can be extremely effective in covering up your port wine stain. Cutis Clinic provides a colour-match service to match you with the ultimate in foundation coverage.
Why Choose A Specialist Laser Dermatologist For Treatment Of Port Wine Stains?
Cutis Clinic is led by Dr Davin Lim, a specialist dermatologist with near unparalleled training in various aspects of laser surgery. Dr Lim treats port wine stains on a daily basis. A consultation will enable thorough assessment prior to treatment and cover potential outcomes, number of treatments required and possible side effects.
What Costs Are Involved With This Treatment?
Please contact us for pricing.
Medicare provides up to 6 rebates per annum for the treatment of port wine stains, depending on the area. Most patients will reach what is known as the Safety Net threshold after 1-2 treatments. Being eligible for the Medicare Safety Net allows you to claim up to 80% of your out of pocket expenses.
Medicare Safety Net patients can receive up to a $129 rebate per session. The number of laser sessions will depend on factors such as the depth of your port wine stain, its location, its (and your) age, and your skin colour.
*All laser therapies are conducted at our specialist Cutis Clinic laser suites.
Specialist Perspective On Laser Treatments For Port Wine Stains.
Port wine stains are common birthmarks occurring in up to three in one thousand births. Laser treatment is the only way of effectively fading or removing them. Ideally, treatment should be conducted as soon as possible, often as early as 6-8 weeks old; however, even long-standing port wine stains can be improved through laser treatment.
I define success as at least a 50% improvement in the size and/or colour intensity. Cutis Clinic now has a success rate of over 90%. Patients must be sufficiently motivated to attend treatments, as it will take 4-8 visits to achieve the desired outcome. Treatment intervals are spaced at intervals of 1-3 months. Downtime following treatment is not usually an issue as the majority of patients can start work a day or two after laser. Bruising subsides within a few days.
How Common Are Port Wine Stains?
2-3 out of 1000 babies born in Brisbane will present with one or more port wine stains, some small, some large. Most children and their parents are unaware that effective laser treatments can fade or remove the majority of port wine stains, especially when treated early.
Can Port Wine Stains Effect Other Areas Other Than Skin?
Yes, they can. Rarely, port wine stains around the eye area can result in abnormalities such as glaucoma.
Extensive port wine stains on the limbs can result in limb growth changes.
All children with port wine stains in these areas should attend a consultation with an experienced paediatric dermatologist to discuss further tests and treatment