Vascular birthmarks are a common disfiguring condition for many people. Vascular birthmarks are distinguished from pigmented birthmarks by their red color which is derived from underlying blood flow. These red vascular birthmarks are also called port wine stains by many people.In contrast, pigmented birthmarks such as the common cafe-au-lait spots are brown in color due to an increased number of pigment producing cells called melanocytes. These cells reside deep with the skin (reticular dermis) and generally do not respond very well to laser therapy.
Laser therapy is very effective for most vascular birthmarks. Without treatment, these birthmarks can become dark purple and thick with skin nodules.
The pulsed dye laser is the gold standard and can be done as a simple office procedure. Generally, several laser treatment are necessary to get a good result. A rule of thumb is 5 treatments for about 50% fading with continued improvement with subsequent treatments.
The pulsed dye laser treatments are done with a skin cooling device to protect the skin. Patients need to avoid sun exposure by wearing sun blocking creams before and after the laser treatment. After treatment, the skin will appear purple or "bruised" for about 10 days before the vascular birthmark begins to fade. Treatment are repeated every 4 to 8 weeks until a satisfactory end point is reached.
