When do I have to remove it?

In principle, a port-wine stain does not need to be removed.It is a benign vascular change that does not represent a health problem. Therefore removal is never a “must”. However, port-wine stains can become a great emotional burden for many children, at the latest when they enter kindergarten.

Especially large port-wine stains on the face are usually a considerable cosmetic problem for those affected. In the end, it is an individual decision whether to have a mole removed on oneself or on one’s child. However, one should consider the child’s interests and future development, especially if port-wine stains are present in particularly exposed areas such as the face. However, there is no medical indication for removal.

Prognosis

The appearance of the port-wine stain can change over time and become both darker and lighter. Usually, however, it does not disappear by itself and, unlike the stork bite, it remains in most cases. The port-wine stain as such does not pose a health risk.

It is benign and has no malignancy potential. This means that it cannot develop into a malignant disease. In the course of time, however, very large port-wine stains, especially on the face, can become a great emotional burden for children.

Secondarily, teasing, exclusion or bullying can follow, even if this is unjustified. This can limit the educational and especially the personal development of the child. After removal, the port-wine stain may reappear in rare cases.

Various localizations

In about 80% of cases, port-wine stains are localized on the face. The congenital malformation, which appears as a reddish spot of varying size, is usually located off the midline of the face. Possible localizations are for example the front sides or cheeks.

An asymmetrical distribution pattern is typical. The port-wine stain grows with the growth of the child. The size can vary greatly – anything from a few millimeters to several centimeters in diameter is possible.

In very rare cases, port-wine stains on the face are part of a symptom complex within a superordinate disease, such as Sturge Weber syndrome. Therefore, in certain cases further examinations are necessary for clarification. In most cases, however, the port-wine stains on the face are harmless.

Very large port-wine stains in the area of the eyes require an ophthalmologic examination, because possibly also deeper lying vessels in this area are affected by malformations. Firemarks on the face are usually removed by laser therapy within the first years of life, because they can become a cosmetic problem for the affected persons. The neck is a rather unusual place for a port-wine stain.

In principle, port-wine stains can spread over the entire body, but the neck is not a typical location. However, port-wine stains are often confused with the so-called naevus flammeus simplex, the stork bite. This is also known as Unna-Politzer-Naevus.

Unlike other port-wine stains, stork bites usually disappear by the first year of life. They occur in up to 60% of newborns and are harmless. Firemarks can also be localized on the forehead.

Basically, port-wine stains are not restricted to a certain body region. They can appear anywhere on the body. Also the forehead is a possible localization.

The port-wine stains on the forehead are usually located rather laterally and show an asymmetrical distribution pattern. They are often easily confused with so-called stork bites of the forehead. However, these are located rather in the middle of the forehead.

Stigma marks are rarely located at the back of the head. About 80% of port-wine stains are located in the face. Since port-wine stains can appear anywhere on the body, the back of the head is also a possible localization. For those affected, port-wine stains on the back of the head usually do not represent a restriction, since they are covered by hair anyway. If necessary, they can also be removed by laser therapy.