The page you are looking for has been moved, changed, or is temporarily unavailable.15 Best Home Remedies to Get Rid of Foot Corn and CallusesPort-wine stains are red or purple marks, often on the face. They are caused by a localised area of abnormal blood vessels (capillaries). Treatment with lasers can give good results although complete clearance is rare. Treatment in early childhood is best. Camouflage creams are an alternative treatment.A port-wine stain is a red or purple mark on the skin. It is usually present from birth. About 3 in 1,000 babies are born with a port-wine stain. Most occur on the face but any area of the skin can be affected.Port-wine stains affect males and females equally. They are not hereditary.Port-wine stains vary in size from a few millimetres across to many centimetres. Their colour can vary from pale red to deep purple. If left untreated, port-wine stains tend to darken over the years as the blood flow through them becomes more sluggish. The overlying skin is smooth and flat at first.
By middle age the overlying skin can become thickened and lumpy (a cobblestone-like appearance).The pictures below show a rather large port wine stain in a baby and a smaller one in an adult. Notice the colour is much lighter in the baby compared to the adult, as port wine stains tend to darken with age.What causes port-wine stains?A port-wine stain is a localised blood vessel problem. The tiny blood vessels (capillaries) in port-wine stains remain wide (dilated). It is like a permanent localised blush. The reason why this occurs is thought to be due to a damaged or faulty nerve supply to the affected tiny blood vessels. The nerve impulses that make the blood vessels narrower are lost so they then stay wide all the time.Although the vast majority of port wine stains are present at birth, they can occasionally develop later on. Possible causes include long-term exposure to ultraviolet light, other types of skin damage and changes in hormone levels. (Hormones are the chemicals that control the way the body works.)
Infections, rare brain tumours and conditions affecting the blood vessels inside the body may also be involved.Apart from their appearance, no other symptoms or problems occur in most cases.However, about 1 in 10 babies born with a port-wine stain on the face have problems of the eye or brain.Eye problems: may develop if the port-wine stain is on the eyelid area. If a child has a port-wine stain next to an eye then an eye specialist will normally check the child regularly until they are adult.Brain abnormalities: are an uncommon association with port-wine stains of the face. This is due to extensive blood vessel abnormalities in the brain (the Sturge-Weber syndrome). Epilepsy and other problems may then develop.Spine abnormalities and varicose veins: can be other associated problems.The majority of children with port-wine stains do not have these complications.Port-wine stains are usually diagnosed on sight as their appearance is so typical. Occasionally scans and other tests are required to rule out some of the other complications such as brain and eye involvement.
Port-wine stains may improve with time but never disappear completely. Laser treatment is usually the treatment of choice for port-wine stains, especially in children.Laser treatmentTreatment with a laser leads to variable improvement. A special fine laser can destroy the tiny widened (dilated) blood vessels. Laser treatment may not clear the port-wine stain completely and repeat treatments are often needed over the years to come. Features of laser treatment include the following:Treatment works best in young children when the port-wine stain is new and flat. Children as young as 2 months old can be treated. It works less well in adults who have had a port-wine stain for a number of years, which may have become bumpy and raised.Treatment tends to work best on smaller port-wine stains of the face and less well on the arms and legs.Generally, the paler the port-wine stain, the greater the chance of excellent results.The laser can cause an unpleasant stinging. Therefore, younger children usually have laser treatment under a general anaesthetic or with sedation.
Local anaesthetic is normally sufficient for older children and adults.Up to ten treatments are needed depending on the size. Treatments are given about eight weeks apart. It is best to have completed all sessions before a child reaches the age of 5 years.There may be pain, bruising and swelling over the treated area for a while after each session.If lasers don't work, surgery is sometimes required.Skin camouflageThis is still a common way of covering port-wine stains. Special coloured cover creams can be put on port-wine stains to improve the skin's appearance. The aim is to find a colour to match the normal skin. Some cover creams can be prescribed on the NHS. Camouflage creams can disguise port-wine stains very well which may greatly increase self-confidence. Changing Faces provides a free skin camouflage service (see below). After advice and instruction, many people become very quick and skilled at putting on camouflage creams each day.There are a number of topical products available for the treatment of SD.
These products are now discussed, categorized by their mechanisms of action, including stimulation of collagen production, increasing elasticity, improving cell proliferation, anti-inflammatory properties and rehydration (Tables and ).The majority of topical products claim to improve the appearance of SD by the stimulation of collagen production in order to increase skin elasticity. StriVectin-SD® (StriVectin®, New York, USA) is a skin repair cream, which is indicated for use on SD, wrinkles and ageing skin.[41] The active ingredient is the molecule NIA-114™. It is thought to work by increasing collagen type I and IV synthesis. However, there is no published evidence for its efficacy on SD.Another topical on the market is Cussons® Mum and Me Bump Stretch Marks Cream (PZ Cussons Ltd, Manchester, UK) which is recommended by the manufacturers for use in preventing SD. It contains Lupin Seed extract, which is used to increase collagen in the skin. It is claimed that this product is clinically proven.
[43] Their topical formulation was tested against 5 ml of skin treatment oil. Twenty-eight women applied the two formulations twice daily for 12 weeks. The results showed that there was a 16% increase in elasticity of the skin using the cream, within 12 weeks. This study was briefly reported on the company website, but there are no published peer-reviewed clinical trials.A number of products contain the active ingredient Centella Asiatica which is suggested to stimulate cell production.[35] Liforma® Stretch Mark Day Gel and Night Cream (Liforma®, Reigate, UK) is a moisturizing cream which contains Centella Asiatica and claims to prevent SD. A product comparative study was undertaken with 25 women, who completed a questionnaire.[44] They reported that Liforma® scored the highest in all outcomes. However, these results were based on subjective measures.Trofolastin has been used in a study for the prevention of SD and also contains the active ingredients; Centella asiatica, tocopherol and collagen-elastin hydrolysates.
It is suggested that Centella asiatica stimulates fibroblasts and has an antagonistic effect against glucocorticoids.[35] A randomized controlled trial compared the treatment cream to a placebo in 80 subjects.[35] Their results demonstrated that 56% of subjects in the placebo group compared to 34% in the treatment group developed SD. Additionally, in women who had a history of SD during puberty, the treatment cream gave 100% prevention of SD, compared to 89% in the placebo group.Clarins® Stretch Marks Cream (Clarins® Ltd, London, UK) is indicated for reducing the appearance of SD. The active ingredients in this product are, Crowberry and Centella Asiatica extracts, olive, coconut and palm oils and siegesbeckia. There are no clinical trials associated with this product.Tretinoin is a topical used for SD and has been studied in four clinical trials.These studies have shown that it has been used successfully in the treatment of striae rubrae and is of limited value in striae albae.A randomized controlled trial was conducted with 22 subjects who had striae rubrae.
[45] It was administered at a dose of 0.1% daily for 6 months. The results showed a reduction in the length and width of SD. Adverse effects were reported, including erythema or scaling in the first 2 months. Another randomized controlled study used a dose of 0.025% of tretinoin daily for 7 months, in 11 women with SD. There was no difference compared to placebo and the topical was ineffective in improving SD. However, the small sample size could have affected this.A case series also evaluated the therapeutic effect of tretinoin, in 20 subjects with SD (type not stated).[34] Tretinoin was applied at a dose of 0.1% daily for 3 months. The findings demonstrated a reduction of 20% in the length of SD. However, there was no control in this study and no randomization. A prospective randomized, open-label study compared the effect of topical 0.05% tretinoin cream vs. dermabrasion in the treatment of striae rubrae. They showed that both treatments were efficacious on SD but there were no differences between treatments.
Bio-Oil® is recommended by the manufacturers for use in helping improve the appearance of scars, SD and uneven skin tone. There have been two randomized controlled studies performed to assess the efficacy of Bio-Oil® in improving the appearance of SD.[48, 49] However, these studies were only reported on the company website and the full details and results of the studies are not available. The first, a single-blinded, randomized controlled trial, demonstrated that 50% of subjects had improvement in appearance of their SD at 8 weeks.[48] As this study was only single blinded, this could have led to a positive bias. Additionally, the magnitude of the change recorded was small and there was a small sample size.The second double-blinded, randomized and placebo controlled trial involved 38 subjects of various ethnicities, different causes of SD and different locations of SD.[49] The results demonstrated improvement in the appearance of their SD up to 8 weeks.Kelo-Cote® (Sinclair Pharma plc, London, UK) is a silicone gel, which has been recommended for use on atrophic scars resulting from acne, chickenpox and SD.
The website states that in clinical trials, 75% of subjects advocated the use of this topical for improving the appearance of existing SD. However, the full information regarding these trials is not available. In a double-blinded, controlled trial, the effects of this topical formulation were compared to a placebo on SD, using non-invasive objective measures and immunohistochemical analysis of sequential tissue biopsies.[39] Both histological and clinical data demonstrated that melanin increased, whilst collagen, elastin, vascularity and pliability decreased over the 6-week period with both gels. Furthermore, collagen levels were significantly higher with the treatment gel and melanin levels were significantly lower with the treatment gel compared to the placebo. The benefit of this topical formulation remains unknown, as the changes in the skin could have been due to the effect of massage.Another product by the same company, named Kelo-Stretch™ (Sinclair is Pharma plc), contains titrated Centella Asiatica extract (0.5%), sweet almond oil and shea butter.
It is claimed that the scientific evidence for this product was demonstrated in a study of women using this topical twice daily. They noted a significant improvement in skin elasticity, a 10% reduction in the width of SD and 60% of subjects noted a reduction in existing SD.[50] This study has not been published.Apothederm™ Stretch Marks Cream (Apothederm™, Bothwell, WA, USA) claims to strengthen the skin and repair existing SD, by increasing collagen levels and reducing the appearance of striae rubrae and striae albae. The active ingredients include natural emollients: shea butter, cocoa butter, olive oil and meadowfoam seed oil. A dermatologist, used this product on subjects with SD and demonstrated positive results.[51] This study has not been published.Skinception™ Intensive Stretch Marks Therapy Cream (Skinception™, Johnson City, Tennessee, USA) contains active ingredients (Regestril, Darutoside, Pro-Col-One and Pro-Sveltyl) to promote the production of collagen. It is claimed that this product is clinically proven, although no information is published.