Marked at Birth: Normalising Port-Wine Stain Birthmarks

What are birthmarks?

Birthmarks are typically defined as an unusual, permanent mark on someone’s body which is there from birth. The term ‘unusual’ makes them seem unnatural. Yet, they are precisely the opposite. Birthmarks are caused by natural mutations to particular genes.

I will be focusing on port wine stains in particular, the type of birthmarks that I have all over my own body. 

How are port wine stains different from any other types of birthmarks? 

The Great Ormond Street Hospital defines a port-wine stain as a flat, red or purple, vascular birthmark caused by abnormal development of blood vessels in the skin, which is present at birth. It is sometimes referred to as a capillary malformation. Rarely, port wine stains can become thicker and darken over time, developing a ‘cobblestone’ appearance with raised bumps and ridges.

As with other types of birthmarks, the change in blood vessels is caused by a mutation occurring early in pregnancy while the baby is developing in the womb. This change in the gene is not inherited. It is also not known to be related to anything that happened during pregnancy. Hence, the mother cannot be to blame for the cause of her baby’s birthmarks as it is an entirely natural process. The same is true of vitiligo, which causes pale white to develop on the skin, or other skin conditions that are often taboo. This perception of birthmarks as abnormalities needs to adapt.  

Though pigmented and vascular birthmarks are very common, with around ten per cent of new-borns having some birthmarks, about three in every 1000 children has a port-wine stain – just 0.3 per cent. Girls are twice as likely to have a port-wine stain as boys with unknown reasons why. Port-wine stains can appear anywhere on the body, in most cases on one side of the body only, but occasionally on both sides. About 65% of port wine stains are on the head and neck. 

Are port wine stains associated with any conditions?

Generally, port wine stains cause no problem as the skin is usually flat. The only difference to ‘normal’ skin is that port wine stains are precisely that, pigments of red or purple, just like port wine. However, they do need more protection from the sun, but using a high SPF sun cream should be enough of a safety procedure.

Occasionally, significantly when upper parts of the face are involved, birthmarks are associated with a higher risk of developing particular conditions. For example, children with a port-wine stain around the eye have an increased risk of glaucoma. Additionally, if the child’s port-wine stain is on the skin around the eye, forehead or scalp, there is a chance that he or she may have Sturge-Weber syndrome

Birthmark removal

London’s Great Ormond Street Hospital – where I had my own birthmarks treated – specialise in treating vascular birthmarks in children with laser treatment and cosmetic camouflage. Laser treatment, with a pulsed dye laser, fades a port-wine stain. It may also reduce the ‘cobblestone’ effect that can develop in adulthood. 

The treatment itself includes using a narrow beam of light that is engrossed by the red colour in the blood vessels in the port-wine stain. The treatment is called selective photothermolysis, meaning that the selected tissue containing blood vessels is treated using light that produces heat. Each time the laser beam touches the skin, it treats a small area only a few millimetres across. Great Ormond Street Hospital calls these laser ‘dots’, and most children have lots of ‘dots’ in one laser treatment session under general anaesthetic. 

Kissed by an Angel: My Story

As a little girl, my parents used to tell me that an angel kissed me, and those kisses were present on my body as birthmarks. 

Since I was born in Warsaw, there was little medical development into birthmarks. One of the many reasons why my parents decided to move our family to the UK was for me to have the chance to have my birthmarks removed as they felt it was their fault that I have them. That is not the case.

All over my body, except for on my face, stomach and fronts of my legs, I have red port-wine stains that transform to purple when I’m cold – like a human thermometer. I am fortunate that I do not have any medical conditions that have been caused by my birthmarks and that they are smooth. It is just my skin which I have learnt to love. 

When I was five, and we moved to the UK, I began having laser treatment surgery, though I never felt I wanted to get rid of my birthmarks or that they were in the way of me achieving anything I wanted to. A vital factor of this was having a best friend, who has Ehlers-Danlos Syndrome (EDS), fragile skin that can scar, break or bruise easily, that she did not let alter her personality. Together, we fought against taboos and made these strange differences beautiful. 

Laser treatment was tedious, despite the nurses and doctors being extremely friendly at Great Ormond Street Hospital. The hospital staff were incredible and made the miserable experience soothing. One of the nurses reminded me of my grandma, who gave me a lot of comforts.

I began to hate going on trips to London as I associated it with the pain of laser treatment. The treatment itself included travelling with my mum, an hour to London. I could not eat anything 12 hours before the surgery. At the hospital, I would be prepped for surgery, which was under general anaesthetic, and pictures would be taken of my arms to view the progress.  The surgery itself was carried out within one-two hours, depending on how much lasering was planned for that day. For instance, whether it was just my arms, or my arms and hands, or arms, hands and neck. Overall, I went through the process seven or eight times before I even turned eleven. 

The aftermath of the treatment was the horrendous part. I would wake up in hospital shivering as I would be padded down with ice to soothe the laser treatment ‘burns’. However, to my utmost relief, I was allowed to go back home with my mum after I had woken up entirely and eaten a meal. We would then always go to the same Italian restaurant – where I would usually get free ice-cream as they could see I just had surgery – as a ritual.

There would then be a two-week period of healing where the bruised spots, where the laser dots were marked, were purple and would gradually fade to a lighter red. I looked like a ladybird. The aim, of course, was that after a couple of surgeries, the pigment of the skin would become white, my natural skin colour. The healing process was excruciating as the purple laser spots itched like hell. But, of course, I could not scratch them; otherwise, they would scar. Instead, I had to cover them with a greasy spray or ointment that prevented the itching. As I have a bountiful amount of birthmarks, it took several treatments even to begin to lighten them. All of this was not worth the result for me. So, at ten years old, I decided to tell my parents that I wanted to stop laser treatment. 

Ultimately, I do not care what people think about my birthmarks.

Of course, it makes for some odd situations sometimes. I have had people ask if I’m incredibly sunburnt, whether I’m bleeding and need help or if I have been bitten by red ants and even given ointment that ‘miraculously’ removes the pigment of my skin. 

However, nobody has ever told me that they are ugly.

Most importantly, I do not think they are ugly.

In a way, my birthmarks are a part of who I am. I could not imagine myself without them. 

For me, that would be like losing something special to me. My birthmarks make me unique and stand out from the crowd. Everyone has something different about them that makes them diverse. We should all accept our faults and make them into our vices, no matter what others’ opinions may be. We should all be proud of our bodies and what they do for us, no matter what they look like or whether they have uneven colouring from what is considered the ‘norm’. Celebrating pigmented skin is the new norm! 

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