Mapperley Park Clinic

Treating Port Wine Stains with the Pulsed Dye Laser

What is a Port Wine Stain?
Port Wine Stains are caused by a genetic abnormality of the blood vessels where multiple small 'loops' of capillaries develop before birth. The increased quantity of blood flowing just beneath the skin surface is clearly visible through the skin. Although they begin pink in colour, if left untreated they usually darken over the years and often develop nodules, or granulomas, inside them.

What can be done to remove a Port Wine Stain?
There are a number of lasers that can target blood vessels. Our Pulsed Dye Laser was specifically designed to target sub-surface blood vessels and, after many years of safe use, is still the treatment of choice for a range of vascular conditions.

The Pulsed Dye Laser works by producing a carefully calculated pulse of yellow light that damages the blood vessels that cause Port Wine Stains without damaging the surrounding tissue. The short pulse length causes the vessels to burst open,leaving dark bruising that can take two weeks to clear. However most people with significant birth marks are not unhappy for the area to look slightly worse temporarily in order to gain significant improvement in the long term.

Does it work?
Unfortunately, Port Wine Stains vary quite widely and do not always respond predictably. The response will vary from excellent to disappointing, although all Port Wine Stains will respond to some degree or other. There is now evidence that some port wine stains that do not respond to laser treatment will improve using an IPL system. As we have all vascular lasers and IPL systems available, we will often carry out a mixed test patch using a variety of systems prior to full treatment.

What is the procedure?
Multiple treatments, spread at least 4-8 weeks apart are normally required. Anywhere between 4 and 10 treatments will be required to take the skin to its optimum improvement. To determine the optimum power to be used, a test patch is first required. This will be a group of laser pulses, covering a range of power settings, that will establish at the follow up:

• Which power setting and which system produces the best response
• How effective the response has been

Once a full treatment programme has been decided, the Port Wine Stain will be treated, either all in one session or in sections. Over the course of a number of treatments, the Port Wine Stain will usually reduce in intensity.

Are there any side effects to the treatment?
The main side effect is a short-lived bruising of the skin, which will be noticeable as round purple spots that will last for a week or two before fading away. Small areas may 'crust' or blister but these will usually settle down within a day or two.

Long term side-effects are very rare: up to a quarter of patients experience a transient increase in skin pigmentation that can last for weeks, or even months after treatment. Other very low risks, affecting less than 1% of patients include, hypo-pigmentation and scarring. The treatment is so safe, compared with other lasers, that it is the treatment of choice even on babies and children with this problem.

What does the treatment feel like?
There is no denying the fact that it hurts! However, as the Port Wine Stain reduces, less power is absorbed and, generally, less pain is felt.

Your ability to tolerate any pain largely depends on your pain threshold but in any case, we have ways of reducing the pain including:

• Chilled air cooling: this reduces the heat generated.
• The client may take Paracetamol an hour before treatment (definitely NOT Aspirin or Brufen type drugs)
• Post treatment cooling: also reduces incidence of blistering

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