Port Wine - Patients ask, Dr. Ringpfeil answers
Please feel free to use the blog below to share information about Port Wine or to ask Dr. Franziska Ringpfeil a question that might be of interest to others.
Philadelphia and Mainline Center of Dermatology and Cosmetic Surgery
Port Wine Stains Philadelphia and Mainline Pa
Treatments: PDL, Nd:YAG, KTP
These birthmarks present as wine-colored areas on the skin with or without swelling. They gradually enlarge for the first year of life and do not regress.
Laser treatment is possible at any age, yet the newer the birthmark, the more likely it is to completely eradicate the unpleasant color. Many treatments are often necessary to achieve results, and bruising can be expected with each treatment.
With darker skin types there may be a chance of lighter-color skin remaining at the site of the original birthmark. Scarring is extremely rare.
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My daughter is 9 years old and starting become self conscience of the port wine stain on her arm, chest and upper back. The area is also mixed with nevi anemicus- large and small spots. Her vascular dermatologist did not recommend laser treatment when she was younger as he said it would not be very effective due to the mix of both nevi flannels and nevi anemicus. Any thoughts?
The combination of port wine stain and nevus anemicus is indeed a challenge yet treatment might be attempted if your daughter is motivated. It would be prudent to assess treatment success in one area, e.g. on chest before lasering all. If there is no notable response after 1 or 2 treatments, further treatment should be aborted. It takes several laser treatments in 6 week intervals to reduce a port wine stain. Some port wine stains partially or fully return within years after successful treatment.
I am 37 with a large port wine on my left face, scalp, neck, and upper chest. I have received countless laser treatments since I was 3, with little to no results. I gave up several years ago after being burned and scarred. Then tried again 2 years ago with a new and improved laser with no luck. For the last couple of years I have started having significant hair loss on that side of my head. Is there anything I can do to get results from my port wine? I’m desperate at this point, it significantly impacts my life. Also is there anything that will help with the hair loss from this?
Some Port wine stains can be very hard to treat because they are comprised of many layers of blood vessels that can almost never be targeted by one laser at once. Over time, scar like tissue (fibrosis) occurs in between these vessels which hinders treatment even more. The current approach to treatment resistant port wine stains includes a combination of multiple lasers to reduce fibrosis and increase destruction of the unwanted blood vessels by the lasers that are blood vessel specific. This can sometimes overcome treatment stagnation.
Hair follicles can be restored through hair transplant in areas where hair has thinned due to repeated laser treatments for port wine stain. We recommend not to treat the hair bearing area further when possible.
I am 34 yrs old and I have a port wine stain on my cheek that seems to be getting a bit darker in the last year or a few, sometimes is a bit puffy and occasionally painful in spots, and this summer started feeling
Itchy and dry. There is one area where the skin is a bit damaged, like raw and a bit flaky. Is this normal? I’ve been using sunscreen but was more lax about it earlier in the summer, and I’ve been using a neem oil moisturizer. Is there a different cream
I should be using? I used to get laser treatments as a child but stopped in middle
School. I do not want to get rid of my birthmark. Thanks!
I recommend that you keep your birth mark sun protected at all times and use a moistuizer such as Cerave cream every morning and night. Oils are great sealants but have no power to deliver moisture. If the dryness and rawness does not resolve with three weeks of active hydration, you should schedule an appointment with a dermatologist for evaluation.
Have you ever seen significant improvement for darker skinned patients? I have a port wine stain on my right thigh that I’ve wanted removed for years. I have a light brown/caramel skin tone. I understand that lasers are riskier on darker skinned patients, but I’m willing to try this.
It is more challenging to treat a port wine stains the more pigment is in the surrounding skin. It also takes significantly more treatments because of the limit on the lasers that we can safely use. You should be evaluated in person so that I can judge if treatment makes sense.
I have a port wine stain on my forehead well I guess port wine is like read my birthmark is brown I have hated it forever I am 27 and I just want it removed so bad I have other birthmarks them ones doesn’t bother me as much as the one on my forehead no one wants to get constantly starred at I just don’t want it there no more it makes my self esteem so low I want to be able to get a hairstyle that doesn’t require a bang because I’m trying to cover this ridiculous birthmark would you guys be able to help me out?
Port wine stains can be removed; brown birth marks are not as straightforward to treat. Please schedule an evaluation at our office to learn whether or how your birthmark may be treated.
Can you reverse poikiladerma of civatte? How would you treat this?
Reversal of poikiloderma is performed with pigment correcting lasers such as pulsed dye laser and alexandrite laser. We see great results when the overlying component is red and not as good results when it is predominantly brown.
Good morning, I have a question about treating small hemangiomas that are scattered over my body. About 10yrs ago I had them treat with the V beam laser and gone with one zap. Is this still the recommended treatment for them and if so, can you tell me how much it may cost to have some of them zapped.
Pulsed Dye laser treatment (Vbeam perfecta) is still state of the art treatment for cherry angiomas. The flat ones will always disappear 10 days after the treatment. The elevated ones will take more than one treatment. Pricing depends on the number of cherry angiomas. At this time, the first angioma on each treatment days is $105 and any additional are $20.
about how much will it cost to have a port wine stain birthmark removed from the low back of a 16 year old girl? maybe the size of her hand? a few scattered irregular shapes?
Do you think insurance will cover it? We have a $3000 deductible for individual.
Thanks!
Port wine stain removal takes between 8-12 treatments every 4-6 weeks. The outcome can be enhanced by simultaneous treatment with laser and a topical medication. Some insurances cover port wine stain treatment in visible areas on the face. Very few insurances cover the treatment on the trunk but you should check with member services of your insurance using ICD9 757.32 and CPT code 17108. If your insurance does not cover the treatment, we charge $350 per treatment. Please note that this fee is substantially less than what an insurance company would allow for the same treatment. With your current deductible per individual, about 4-6 treatments would go through insurance but paid by you as the deductible and any additional treatment would be covered by your insurance (unless you had a coinsurance after meeting the deductible). Please calculate what may be best for you.
My daughter has a port wine stain (hemangioma) on her face. It’s not a large, dark port wine stain, it’s more a reddening near and around her eye, cheek, and nose. She has had laser treatments for years (since she has been a year old) but it’s still very prominent. She’s now 10 yrs. old and very self conscious if it.
We tried Dermablend make up, but it looks very “cakey.”
Last time she had a treatment she was burned and now has a scar. 🙁
Do you recommend another treatment option? A different laser?
I keep reading that some birthmarks are being treated and going away in a LOT fewer treatments than my daughter has had. Why isn’t hers going away or being diminished significantly? Thoughts?
Some port wine stains may have a component that is deeper than an external laser can reach and then treatment can be very challenging. While embolization of deeper vessels may be an option elsewhere on the body, in the area around the eye it may not be a safe option. I recommend that you discuss imaging studies with your pediatrician to learn if a deeper component is the culprit for the slow response to treatment. Depending on the findings, an interventional radiologist versed in embolizations may be consulted to see if other measures can be taken.
Hi, I am 26 and have been thinking of having my port wine stain removed for the past 10 years but have not been able to do so do to having small children. However I am at the point where it bothers me everyday just to drop my son off at kindergarten or go on school outings with my children. I also am asked if I need domestic violence help every time I go to a new doctor or am having a child. The outrageous things that people as me that happen. I have Gateway insurance and would love to have it removed since it covers 50% of my face and has now caused glaucoma in my right eye. if you could help or if you work with my insurance I would love the opportunity to schedule an appointment at your office to have this removed from my face.
Thank You,
Jacqueline
Port wine stains can be efficiently treated with pulsed dye laser. It takes several sessions to undo the birthmark. When treated in adulthood, it is possible that years down the road some or all of the birthmark returns but it can be treated again. Laser treatment of the skin will unfortunately not reverse the glaucoma. Most insurance companies cover treatment of port wine stains when they involve the face. This is something that we will be able to check for you after your consultation.