Patients with large and small poit-wine stains have been studied using an intensive interview technique. Those with large defects were shown to have reality problems in common. In addition, their experiences were found to be tempered by individual life events and personality dynamics. Those with small port-wine stains who sought treatment showed no reality problems but experienced great individual psychological problems, which in this study are proved to be the same type. The implications of these findings for prophylaxis against mental illness as well as factors to take into consideration when treating these patients are discussed.