Capillary Malformations

Among the capillary malformations, the port-wine stain, medically known as nevus flammaeus, is the most common form. It is already present at birth and is conspicuous with a mostly pale pink to light red skin coloration. It is not always possible to clearly differentiate it from a hemangioma in the first days of life.

The port-wine stain does not grow in the sense, but changes its coloration and thickness of the skin in the course of life. This thickening (connective tissue hypertrophy) can be very disturbing cosmetically, especially on the face.

If the port-wine stains are in the temporal region of the face, a Sturge-Weber syndrome should always be considered. Since this syndrome is associated with glaucoma (increased intraocular pressure) and vascular malformations of the meninges, this must be clarified. 

For the port-wine stain, the therapeutic focus is on the dye laser (wavelength 595 nm). The aim is to reduce the red coloration and make it more inconspicuous, and also to prevent skin thickening. For this purpose, an early start of therapy is rather recommended. Laser treatment in young children must be performed under anesthesia. Adolescents and adults, depending on the size of the nevus flammaeus, can also consider treatment without general anesthesia. However, it is somewhat painful, despite the application of local anesthetic cream.  

The special feature of the dye laser is that it has a low penetration depth, and absorbs the red blood pigment hemoglobin. This causes the red blood cells and capillaries to burst. Therefore, immediately after the laser treatment there is an increase in redness and swelling, which disappears after about 5-8 days.