Vascular birthmarks are common disfiguring skin anomalies which are often called port wine stains. These birthmarks can be present anywhere on the body but are more common on the head and neck. Port wine stains are known in the medical community as capillary vascular malformations and although they have no malignant potential, they can be severely disfiguring.

There are numerous lasers which are effective in removing vascular birthmarks. The most common and “gold standard” is the pulsed dye laser. The pulsed dye laser is very specific for vascular birthmarks but is somewhat limited due to its depth of penetration. For older patients with thicker vascular birthmarks, I generally combine the pulsed dye laser with a Nd:YAG laser or Alexandrite laser which allows deeper penetration into the skin and a better overall result.

Laser treatment of vascular birthmarks is a process requiring between 5 to 10 separate treatments. These treatments can typically be done in an office setting using topical anesthetic cream. There is about a week of post laser “bruising” which can be covered with mineral based make-up. The treatments are spaced about 6 to 8 weeks apart and it is important to avoid sun tanning during the treatments. A good rule of thumb is to expect about 70% fading with 7 treatments and variable improvement with each subsequent treatment.

In addition to laser birthmark removal, Dr Burns treats all forms of vascular conditions including vascular tumors such as malformations (venous, lymphatic, and arteriovenous) and hemangiomas (common birthmarks of infancy). Dr Burns sees patients over the age of 18 in his adult practice, Dallas Plastic Surgery Institute, and children from birth to 18 years in his pediatric plastic surgery practice, Plastic and Craniofacial Surgery for Infants and Children, at the Medical City Children’s Hospital.

Case 1
Case 2
Case 3



30 minutes


IV sedation or local




Mild pain, brusing


Pigment problems, scarring


Back to work: Immediate with cover up makeup; bruising lasts 1 week


6 weeks after each treatment for optimal fading