Occurring in about 3 out of every 1000 newborns, Port Wine Stains (PWS) present as pink, red or purple, generally flat and often misshapen discoloration on an otherwise normal skin. Depending on the size and location of the PWS, the most common treatment is laser, and less commonly surgery or radiation. Lasers, if used properly, and with the appropriate wavelength, can give effective results without downtime.
Lighter port wine stains or pink based port wine stains tend to respond well to visible light wavelengths such as Broad band light (BBL), pulsed dye lasers and the KTP, a 532nm wavelength laser. It is suggested to start treatment as early as two months of age and up to 8-10 treatments should provide for best results. Certainly, an adult can treat successfully as well, depending on the colour and location of the PWS, but treating early increases efficacy as well as alleviating social stress to the patient if the PWS is visible on the face or neck.
The visible light devices mentioned above all give similar results, with variance due in most cases to the location and age of the PWS, the colour and of course, the experience of the technician. Occasionally the Nd-Yag can be effective on the body, but can be too strong for the face. There are always challenges with any port wine stain or for any correction of the skin where vascularity is involved. Treating at purpuric settings is well accepted in the laser field by the skin experts (dermatologists), however the bruise-like look of the purpuras can be more than the patient is willing to live with for a few weeks after treatment. It is important to be up front and honest with the patient when dealing with port wine stains. Sometimes the birthmark will look worse before it gets better.
For years I have been treating port wine stains with the equipment available to me at my clinic. Until recently, my patients were getting ok results, with the birthmarks often fading to some degree but not wholly disappearing. However since the addition of our Cutera Excel V laser, encasing both the KTP 532nm and the Nd-Yag 1064 nm wavelengths, results have been much more promising. With quicker results, less treatments and little to no discomfort, I get excited when a patient comes in with a port wine stain. I feel that I am now properly equipped to help get rid of or substantially lighten the stain with confidence. While there is a good chance that a bruise may occur, they tend to fade quickly in most cases and are well worth it in the end.
I think the most important thing is to be sure the patient is informed that it will take multiple appointments to get rid of the PWS, that there may be some transient discoloration during the process, and that the results vary from person to person. The treatment is quick, often taking only 5-10 minutes to treat, and is rarely uncomfortable, with some patients saying they feel nothing at all during the session.
From the youngest of children to the elderly, port wine stains can be greatly improved in most cases. With the addition of our Cutera laser, efficacy has improved exponentially. If you have a port wine stain, and you are not willing to live with it anymore, isn’t it great to know you won’t have to? Drop by for a skin assessment at Toronto Dermatology Centre. No referral is needed to treat port wine stains or any vascular condition of the face or body, and consults are fast and complimentary too!
~ Sheri Roselle, Medical Esthetician at Toronto Dermatology Centre