Birthmarks

Strawberry hemangiomaThis type of hemangioma is usually raised up a bit from the skin and bright red like a strawberry. This bright red coloring is due to numerous, dilated blood vessels found close to the surface of the skin. These hemangiomas usually go away on their own by age ten (age five in almost half of children). Most do not require any treatment, unless they ulcerate or are located in places where they could impair normal body functions, such as around the mouth, nose, eyes, anus, or throat. Cavernous hemangiomaThis type of hemangioma is beneath the skin. It is puffier than a strawberry hemangioma and also more bluish in color. These types of hemangiomas are less likely to resolve on their own. Facial hemangiomas are occasionally associated with similar vascular malformations of the brain, so your physician may recommend MRI imaging to determine whether this is present. Macular stainThese are often called angels kisses or stork bites. These harmless birthmarks are pinkish or light red and can be found anywhere on your child's body, but most commonly on the back of the head and neck. Usually they are barely visible. No treatment is necessary for this type of birthmark.MolesMoles appear as dark brown or black spots. Nearly everyone has small moles. They usually begin to appear after birth and are actually small groupings of colored (pigmented) skin cells.

Mole 2008 Nucleus Medical Art, Inc. Mongolian spotsThese flat birthmarks on the surface of the skin have a blue-gray color and are often located on the buttocks or base of the spine. These types of birthmarks are generally harmless, however, they are sometimes mistaken for bruises. They tend to disappear by puberty.Port-wine stainsPink, red, or purple colored blotches on the skin. Their size varies and can be found on the face, neck, arms, or legs. Although there are treatments to minimize the appearance of port-wine stains, they are permanent. Large port-wine stains on the face may be indicative of a condition called Sturge-Weber syndrome that can result in seizures and mental retardation. Congenital hairy nevus (giant hairy nevus, bathing trunk nevus)this is a dark, textured mole, present from birth. Many of these will also be covered at least in part with hair, but some are not. They may be very large, covering the abdomen and thighs in a bathing trunk distribution, or smaller. They may be multifocal. This particular birthmark can develop into melanoma at some point in life. It is generally removed as soon as feasible, depending on size, location, and need for reconstructive surgery to achieve a good cosmetic result.

CausesThe exact cause of birthmarks is unknown. Risk Factors A risk factor is something that increases your chances of getting a disease or condition. The following factors increase your chances of developing particular birthmarks: Hemangiomas are more common in females and premature babiesMongolian spots are more common among Asians, East Indians, Africans, Native Americans, and HispanicsCaf-au-lait spots are more common in African-Americans than other ethnic or racial groups SymptomsIf you or your child experiences any of these symptoms do not assume it is due to birthmarks. These symptoms may be caused by other health conditions. If you experience any one of them, see your physician. Symptoms include: Changes in the color of the skin (lighter or darker than usual)Lumps or swelling on the skinChanges in texture of the skinNew lesions on the skin Birthmarks: May differ in size and appearanceAre most likely present at birth or appear in the first few weeks or months of lifeAre commonly found on face and neckMost of these birthmarks, though cosmetically undesirable, are generally harmless. However, hemangiomas and port-wine stains may produce some complications: Hemangiomas

Open sore or ulcerInterference with the appearance or function of nearby structures (eg, eye or mouth)Excessive bleeding after an injurySudden and rapid growth Port-wine Stains Emotional and social complicationsInterference with the function of nearby structures (eg, eye)Growth problemsEasy bleedingOn rare occasions, moles can become cancerous. Any suspicious pigmented lesion should be examined by a physician and either closely observed or removed. DiagnosisYour doctor will ask about your symptoms and medical history, and perform a physical exam. Birthmarks are usually diagnosed based on the appearance of the skin area. If there is any question of the diagnosis, a biopsy may be taken for laboratory examination and you may be referred to a dermatologist, a doctor who specializes in skin disorders. Treatment Most birthmarks can and should be left alone. Treatment is generally recommended if the birthmark is: Cosmetically undesirable and unlikely to resolve on its ownCausing discomfort or complicationsHas the potential to develop into a more serious condition (rare)Treatment options include the following:Corticosteroid medicationsA type of anti-inflammatory medication that can be given orally (by mouth) or locally injected (preferred). It is the most common treatment for rapidly growing hemangiomas. However, corticosteroid medications are for long-term use and, if given orally, have a number of risks including poor growth in children and elevated blood sugar.

Laser therapyLasers can be used to prevent growth of hemangiomas and to remove hemangiomas and port-wine stains.SurgeryMay be used to remove a pigmented lesion (eg, a mole) or remove residual scars left behind from other treatments.Cosmetic alternativesThere are many make-up products that effectively cover up birthmarks. These are sometimes referred to as corrective cosmetics and include concealers, neutralizers, and camouflage products.Regular check-ups with your primary care doctor or dermatologist are important for lesions undergoing treatment or observation. PreventionThere is nothing that you can do to prevent birthmarks. Birthmarks are congenital (something with which you are born) and apparent at birth or by the first few weeks of life. RESOURCES: American Academy of Dermatologyhttp://www.aad.org The SturgeWeber Foundation (SWF)http://www.sturge-weber.com Vascular Birthmark Foundationhttp://www.birthmark.org CANADIAN RESOURCES: BC Health Guidehttp://www.bchealthguide.org Canadian Vascular Birthmarkshttp://www.canadianvascularbirthmarks.com References: Cosmetic alternatives to birthmarks. Vascular Birthmark Foundation website. Available at: http://www.birthmark.org/cosmetic.php . Accessed August 16, 2005.

Guttman C. Clinical, molecular features aid worrisome birthmark recognition. Dermatology Times . April 2005;26(4):66-67. Hemangioma information. Vascular Birthmark Foundation website. Available at: http://www.birthmark.org/hemangiomas.php . Accessed August 16, 2005. Mongolian blue spots. Medline Plus. US National Library of Medicine of the National Institutes of Health website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/001472.htm . Accessed August 18, 2005. Run, spot, run! American Academy of Dermatology website. Available at: http://www.aad.org/public/Parentskids/KidsConnection/KCRunSpotRun.htm . Accessed on August 16, 2005. Strawberry hemangioma. Mayo Clinic website. Available at: http://www.mayoclinic.com/invoke.cfm?ObjectID=A71EAE4D-E0FE-4BE9-AC8C585B0146E35C . Accessed August 16, 2005. Vascular birthmarks. American Academy of Dermatology website. Available at: http://www.aad.org/public/Publications/pamphlets/VascularBirthmarks.htm . Accessed August 16, 2005. Last reviewed January 2008 by Ross Zeltser, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.