Early Intervention for Port-Wine Stains

Early intervention dramatically improves treatment outcomes, Roy G. Geronemus, MD, FAAD, told attendees of the 2025 American Academy of Dermatology (AAD) Annual Meeting in Orlando, Florida.¹ Geronemus, a board certified dermatologist from New York City, spoke as part of a session on the advancements in treating vascular birthmarks, particularly port-wine stains in young children.

According to Geronemus, starting treatment during infancy and scheduling frequent sessions leads to better, faster, and more complete results. With advancements in laser technology, including larger spot sizes and improved cooling mechanisms, these treatments have become more effective and safer for young patients. “If we begin treatment during very early infancy and treat frequently, we get a faster, more complete outcome and an overall more beneficial response for the patient,” he told Dermatology Times in an interview.

Geronemus has extensively researched this approach and published findings in dermatology journals. His 2019 study followed 197 infants under the age of 1, demonstrating remarkable treatment success.² In that study, he and his colleagues concluded, “treatment of PWSs in infancy was both safe and effective. Early intervention allows for treatment without general anesthesia, maximizing the chance to achieve clearance before school age and thereby minimizing the negative outcome of PWSs for both the patient and the family.”

In a more recent study, Geronemus examined weekly treatments, further reinforcing the safety and efficacy of early intervention. “The responses were very, very effective with incredible safety—no scarring or pigmentation changes,” he told Dermatology Times.

Port-wine stains, if left untreated, may darken and thicken over time, potentially leading to complications. Geronemus’s work underscores the importance of addressing these vascular birthmarks as early as possible to ensure the best cosmetic and medical outcomes.

With growing evidence supporting early laser treatments, Geronemus encouraged clinicians to consider this approach for young patients with port-wine stains. The ability to safely and effectively minimize these birthmarks in infancy can make a significant, lifelong impact on affected children.

References

1. Geronemus RG. Critical Gaps and Controversies in Laser Treatment of Port Wine Birthmarks and other Vascular Anomalies. Presented at: 2025 American Academy of Dermatology Annual Meeting; March 7-11; Orlando, Florida.

2. Jeon H, Bernstein LJ, Belkin DA, Ghalili S, Geronemus RG. Pulsed Dye Laser Treatment of Port-Wine Stains in Infancy Without the Need for General Anesthesia. JAMA Dermatol. 2019 Apr 1;155(4):435-441.