Pediatric Plastic Surgery

Port-Wine Stain

Bye-Bye, Birthmark

When her son, Joseph, was born, Kim Dibiase immediately noticed a large spot that stretched across one side of her baby's face. It was a port-wine stain-a flat, purplish-red overgrowth of blood vessels in the skin. This type of birthmark shows up in about three of every 1,000 newborns and tends to darken and thicken as the child ages. "I was a little in shock," Kim recalls. "Having this baby was the greatest joy of my life, but I felt sad for him too."

Once the doctors had ruled out a more serious medical syndrome associated with port-wine stains, Kim and her husband, Joe, focused on treatment options, ultimately pursuing laser therapy. The decision to seek treatment was not a casual one. But the Ocean Township, New Jersey, couple knew that such a large birthmark could affect their son's self-esteem.

Joseph started laser therapy (which damages the blood vessels and causes them to shrink) when he was 7 weeks old and continues to get periodic treatments. "My belief is that we do better if we begin treatment during infancy," says his doctor, Roy Geronemus, M.D., director of the Laser and Skin Surgery Center of New York, in New York City. The therapy is mildly painful (Dr. Geronemus compares it to a rubber band snapping against the skin), so it is emotionally draining for Joseph-and for his parents. "He screams through the whole thing. It probably lasts six minutes, but it seems like an eternity," Kim says.

After treatment, Joseph's face is swollen and bruised for a few days. But the couple stays focused on the fact that, after 19 treatments (the frequency has dwindled to about twice a year), the birthmark has faded dramatically. Though he can't predict how many more treatments Joseph, now 4 years old, will need, Dr. Geronemus is confident that the stain will eventually be nearly invisible. The laser therapy will also keep the area from becoming thick, bumpy, and prone to spontaneous bleeding.

In the meantime, Kim finds comfort in the pictures she has been taking of Joseph's face since treatment began, and in the reaction of an adult acquaintance who has a port-wine stain covering half of his face. Before beginning treatment, Kim recalls, "I asked him, 'If this treatment had been available when you were a child, would you have wanted your parents to do it?' His response: 'Absolutely.'"

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