Port-wine naevi or angiomas

Port-win naevi or angiomas

A port-wine naevus (angioma or naevus flammeus) is a benign, congenital skin lesion in which all the capillaries in a given skin area are dilated due to a defect in the closing mechanism of these capillaries. The disfiguring angiomas sometimes have a reddish-purple colour and are therefore also called wine spots. Wine spots on the skin have no identifiable cause and are rarely familial.

Laser treatment of port-wine naevi

Port-wine naevi or angiomas have been treated successfully by means of selective vascular lasers since the nineties. Such laser devices produce a very powerful light wave with a single wavelength, which is perfectly aimed at the target it needs to reach. In the case of wine-port naevi or angiomas, the red blood cells in the dilated capillaries are our target.

A high energy dose and the extremely short pulse duration results in selective damage of the dilated capillaries. Laser treatments are very targeted and precise so that the surrounding cells and tissues are hardly damaged. The damaged blood vessels are then cleared by the body and replaced by normal capillaries.

The optimal result of a single laser treatment for a port-wine naevus can be expected after approximately two months. At which time the next laser treatment can be performed. Although the final outcome of any laser treatment and how many treatments you will need, can never be predicted, we can say that the laser treatment of port-wine naevi always consists of several sessions with an interval of at least two months.

Depending on the type of angioma more than 10 laser treatments can sometimes be necessary in order to achieve an optimal result. The energy of each laser treatment is absorbed by the upper layer of the remaining capillary angiomas. This way, the port-wine naevus is removed layer by layer.

Types of laser devices for the treatment of angiomas

At the Cutaneous Laser Centre, we use three types of laser devices for the treatment of port-wine naevi or angiomas:

  • the pulsed dye laser
  • a 532 and 1064 nm variable pulse Nd-YAG laser
  • a 800 nm diode laser

In a number of patients, during one treatment session, we sometimes use two laser devices with a different wavelength sequentially.

Is laser treatment for port-wine naevi or angiomas painful?

  • Laser treatment for port-wine naevi is painful.
  • That is why we usually treat angiomas in children with the aid of an anesthetic cream.

What to expect after the laser treatment?

  • Immediately after the laser treatment, a reactional redness will occur and also often a slight swelling (oedema).
  • In particular, when the pulsed dye laser is used, a purpuric dyschromia (from grey to blue) can occur.
  • Complications are rare.
  • You can reduce the risk of a temporary brown dyschromia (hyperpigmentation) or lightening (hypopigmentation) significantly by avoiding treatments during the summer.
  • The risk of lightened texture or cicatrisation is small.

Aftercare following laser treatment for port-wine naevi or angiomas

  • For comfort reasons, it is recommended to cool the skin down after treatment with cold, wet compresses or washcloths, for example, or possibly with Flammazine or Flamigel.
  • In the case of any scab formation, you can also apply Flammazine or Flamigel ointment to the treated area.
  • Rubbing or using soap is not recommended during the first few days after treatment.
  • If you want to wash the treated zone, we recommend to only lightly dab it with water during the first few days.

What you also need to know

  • In many patients, we achieve up to 75% fading, in others, we manage to achieve 95% fading. Even with an excellent result, a certain reactivity of the blood vessels usually remains. In the case of effort or cold temperatures, a light red dyschromia can arise in the original area where the port-wine naevus used to be. 
  • Since April 1st, 2007, an RIZIV nomenclature exists for laser treatment of port-wine naevi (naevus flammeus) to the face, neck or hands. For all other parts of the body, there is no nomenclature. For reimbursement through national health insurance, a number of additional conditions also need to be fulfilled. These can be discussed during the consultation.
  • During treatment, the patient, the physician(s), staff and any attending family have to wear special glasses to protect the eyes from the laser light.
  • Before and after treatment, digital photographs can be taken to optimally assess the evolution and end-result.

If you have any question about the laser treatment of port-wine naevi or angiomas, do not hesitate to contact us.