I had a small portwine stain on the side of my nose and over my eyelid. At birth, the only option open to me (thirty-odd years ago) was a skin graft, which my parents vetoed on the grounds that the birthmark was by my eye. Laser treatment didn't become available until the early 90s.
I had laser pulse dye treatment in 1990 when laser treatment first started. It faded it by around 50% so it still required make up to cover it. However, in the last four or five years I have had four more sessions and it is now almost completely gone. Without pain relief it can be very uncomfortable. My consultant described it as an elastic band snapping against the skin, but I think because it was on the area around my eye and nose, where the skin is thin and sensitive I found it much sharper than that. However, I didn't use local anaesthetic and I have heard this helps hugely. They apply a topical anaesthetic cream to numb the area and it does dull the sensation. I never bothered as I was always in a bit of a rush (in my lunchhour, on my way home) when I had the treatment and didn't want to sit for half an hour waiting for the cream to work. Plus, as an adult I could rationalise the pain. It's also a blink-and-it's-gone pain - it lasts literally as long as the laser pulse (so a pulse, a second). The laser treatment causes deep black bruising which fades over the course of a week, revealing the lighter area underneath, and you can get a bit of swelling, although that does depend on the area. I got a slightly swollen eye, but I think becuase the eye area is so sensitive.
However, if I were a child or had a child with a port wine stain I'd use the cream. It would reduce it to a mild discomfort and certainly not something they would cry over. YOu could also offer some calpol beforehand as this might take the edge of things also.
Laser treatment has fantastic results. Mine really is almost gone - one more session and it will have vanished, which feels strange as it has been part of me for so long. It never bothered me as a child as it just seemed normal but I did get teased when I was older - actually by adults, who should have known better and often said unkind things (incredible really). Children were occasionally curious ("What's that mark on your face?) but were satisfied with the answer. It was only the unkindness of adults that actually made me very sensitive about it and want to have it removed. It's personal choice but I'm glad I did.
K