Port Wine Stain

What is a port wine stain?

A port wine stain is a permanent birthmark. It’s a smooth, flat, pink, red or purple patch on a newborn that may get darker and raised or bumpy over time.

A port wine stain usually appears on the face but can affect other areas of the body.

The condition gets its name because it looks like someone spilled or splashed dark red wine on the skin. It’s also called nevus flammeus.

How common is nevus flammeus?

About 3 of every 1,000 babies have a port wine stain. The condition affects babies assigned male at birth (AMAB) and babies assigned female at birth (AFAB) of all racial groups.

Do port wine stains go away?

Port wine stains don’t go away without treatment.

Do port wine stains get worse with age?

Over time, port wine stains usually get darker and thicker. They also may become raised rather than flat and smooth.

What causes a port wine stain in babies?

Port wine stains result from abnormally formed capillaries (tiny blood vessels under your skin). The capillaries dilate, which means they’re more open or stretched out than normal.

But scientists aren’t sure what causes the abnormal capillaries. There have been cases where multiple family members have it, even if there are no known genetic mutations.

What does a port wine stain birthmark look like?

A port wine stain is a pink, red or purplish splotch on the skin. It has clear borders where the birthmark starts and stops.

These birthmarks can occur anywhere on the body, but most commonly on the:

• Face.
• Neck.
• Scalp.

In children, port wine stains are usually smooth. As a child grows, the birthmark grows too, but it stays in proportion. Port wine stains may get thicker and darker over time and start to feel like pebbles under the skin. They also may be more likely to bleed after injury, which can be difficult to control.

Are port wine stains harmful?

Port wine stains are usually harmless and don’t lead to any medical problems or pain. But for many children and teenagers, the birthmarks can be embarrassing, especially large, dark spots on the face. This can lead to problems with self-esteem and socialization.

Rarely, port wine stains occur in people with Klippel-Trenaunay syndrome or Sturge-Weber syndrome. People born with one of these syndromes have abnormally developed blood vessels in other parts of their body and should be evaluated for potentially serious complications.

If a port wine stain becomes larger and raised later in life, it may be a sign of or cause of other medical issues. For example, the mark may bleed more easily than other skin when it’s injured. Also, people with port wine stains around their eyes may have a higher risk for glaucoma.

How is a port wine stain diagnosed?

A healthcare provider can diagnose a port wine stain simply by looking at the skin.

These are generally diagnosed at birth. Healthcare providers will need your family history. Port wine stains are usually just a cosmetic issue, affecting only the skin. Your baby’s provider will check them for signs that there may be other health issues (a syndrome like Sturge-Weber).

If the provider has any concerns or needs to rule out a medical problem, they may order other tests. Examples include:

• Eye tests to measure pressure in the eye.
• Imaging tests such as an X-ray, CT scan or MRI.
• Skin biopsy.

How is a port wine stain treated?

Port wine stains that aren’t associated with other medical concerns don’t require medical treatment. But some people choose treatment because of:

• Increased risk of bleeding with trauma and associated risk of infections.
• Potential for thick, bumpy skin and disfigurement later in life.
• Self-esteem and socialization.

The most common treatment is laser therapy to shrink the blood vessels and fade the birthmark. The treatments are most effective in younger patients when the blood vessels are smaller.

Laser therapy treatments are brief, lasting a few minutes. Most people get repeat treatments every couple of months. The laser may make the skin red and sore, like a sunburn. If the treatments are very uncomfortable, you can ask for a numbing spray or cream. Very young children may even receive general anesthesia, so they sleep through the treatments.

How can I prevent port wine stains?

Scientists aren’t sure what causes port wine stains. The birthmarks aren’t caused by anything specific that happens during pregnancy, so you can’t prevent them.

What can I expect if I have nevus flammeus?

Port wine stains don’t go away on their own. Without treatment, they will likely get larger. They also might get darker, thicker and bumpy.

For most people, these birthmarks are cosmetic and don’t cause medical problems. But if you have a port wine stain, your healthcare provider should examine it from time to time.

Laser treatments may fade the birthmarks, but results vary widely. Even after successful treatments, nevus flammeus can come back or get dark again years later.

How can I help my child cope with a port wine stain?

A port wine stain can make a child self-conscious or embarrassed, especially if the birthmark is on the face. Some people might stare or make insensitive comments. To help your child, consider these strategies:

• Discuss the birthmark openly with your child, using simple language.
• Explain that the port wine stain is a unique, special, colorful part of them.
• Offer to try cover-up makeup if the child wants to minimize the mark.
• Discuss the port wine stain with the people your child interacts with frequently.
• Make sure teachers provide a supportive plan for your child to learn and socialize, free from bullying.
• Practice how to respond to people who ask about it. For example, “It’s just a birthmark.”
• Treat the birthmark like any other personal characteristic, like eye color.

Does a port wine stain need any special skincare?

A port wine stain can get dry, so make sure you moisturize it.

If the skin is broken (for example, a scratch or cut), it can bleed more than normal skin. Make sure you clean the area gently with soap and water. Then put pressure on it with a clean bandage.

When should I get medical attention for nevus flammeus?

Talk to a healthcare provider if a port wine stain:

• Bleeds, especially if it won’t stop.
• Gets infected.
• Hurts.
• Itches.
• Oozes.

A note from Cleveland Clinic

A port wine stain (nevus flammeus) is a permanent birthmark that usually appears on the face. On a newborn, it’s a smooth pink, red or purple flat discoloration, which may get larger, thicker and darker over time. If you or your child has a port wine stain, talk to a healthcare provider. Rarely, a port wine stain may be related to a syndrome.