Capillary Malformation (port wine stain)

What is a capillary malformation?

Capillaries are small blood vessels that connect the arteries to the veins. In a capillary malformation, the capillaries are larger than normal (dilated). This birthmark also is called a port wine stain. The capillaries in a capillary malformation:

• Are close to the surface of the skin. This makes the skin color pink to red.
• Are a flat birthmark.
• Are present at birth (congenital).
• May be hard to see because of the baby's skin color.
• Can be on any area of the body or in many areas, but are most common on the head and neck.

The cause is not known. They are not caused by anything the mother did or did not do while she was pregnant.

How is it diagnosed?

An exam of the skin is done. Normally no special tests are needed. Capillary malformations only affect the skin, but they may be a sign of something more serious under the skin. If the malformation is on the face, spine or on top of swollen soft tissue, your child should see a pediatric specialist. This doctor should be an expert in blood vessel birthmarks.

How is it treated?

Most capillary malformations do not need treatment. The most common treatment is pulsed-dye laser. Success with laser treatment varies for each person. The laser lightens the redness of the skin. It works better on the face, neck and chest. It can take many treatments to get the full effect of the laser. The redness fades but may not disappear completely. The laser may help keep the affected skin from getting a deeper red or purple color later in life. It may also keep the skin from thickening over time.

What are the possible complications?

A capillary malformation:

• Gets darker and thickens the skin over time. When it gets thick it may bleed easily. Laser treatments seem to help the skin stay lighter in color and thinner.
• May be a sign of glaucoma if it is on one or both eyelids. A sign of glaucoma is increased pressure in the eye. This can lead to blindness. Yor baby should be checked for glaucoma by a pediatric ophthamologist (eye specialist) shortly after birth. Your baby should be seen on a regular basis to monitor the pressure.
• Will not go away if left untreated. The malformations don't spread to take over a larger area, but they do grow as the baby grows.
• Rarely needs surgery. If there is overgrowth of soft tissue under the malformation, surgery may be an option.
• May be a sign of a more serious syndrome. The doctor will talk with you if there may be something more serious.

What about my child's self-esteem?

• Parents may have a range of emotions when their baby has a birthmark. It can be very hard when the birthmark is on the head or neck. People may stare, make rude comments or accuse you of child abuse.
• Children often become aware of their appearance around 4 years of age. It is important to watch for signs from your child. Some children try to hide their birthmark or refuse to go places they used to like.
• There are resources that can help with the emotional aspects of a birthmark. The vascular anomalies team is one resource. The hospital also has Child Life specialists who can help. Sometimes family members like to talk to another family with the same concerns. The vascular anomalies team can help you make contact with another family.

Alert: Call your child's doctor, nurse or clinic if you have any concerns or if your child has:

• Sudden swelling.
• An infection that will not heal.
• Bleeding that will not stop.
• Special health care needs not covered by this information.