What are vascular birthmarks?
Vascular birthmarks are made up of blood vessels clustered together in the skin. They can be flat or raised, pink, red or even bluish in colour. They occur in about one in three of all newborns.
While most vascular birthmarks disappear with time, some remain permanently. An accurate and early assessment of all vascular birthmarks is essential if the child is to receive the appropriate treatment.
What causes these birthmarks?
Vascular birthmarks are the result of an abnormality in the way blood vessels form beneath the surface of the skin as a baby is developing in the womb. Some are not visible until after a few weeks of life. Though the actual cause is unknown, we do know most vascular birthmarks are not inherited.
What are the most common types of vascular birthmarks?
There are many different types of vascular birthmarks. The most common are known as stork marks and strawberry marks.
* Stork marks These are usually manifested as marks on the back of the neck, the middle forehead or upper eyelids. Facial ones tend to disappear by the time the child reaches age two.
Treatment No treatment is required for stork marks.
* Haemangioma Haemangiomas, or strawberry birthmarks, affect around one in 20 babies. They are not usually visible at birth but can grow rapidly over a period of three to six months. The most common complication is bleeding and ulceration.
Treatment Fifty per cent will disappear by the age of five years. However, medical treatment may be required in some circumstances where they appear in sensitive areas of the body such as the eyes, head, nose and mouth. Only about 20 per cent of these will require treatment following complications.
Each case is different and requires a doctor to decide on the most appropriate course of treatment.
If a child's haemangioma bleeds profusely or becomes painful and ulcerated, the ulcer should be kept clean and covered with a dressing. Medical attention should then be sought.
* Port wine stains Also called nevus flammeus, these are present at birth and are flat, dark pink, red, or purple in colour. They affect three in 1,000 newborns. With age, they may become darker and develop surface lumps.
Without treatment they are permanent. A child can have a port wine stain anywhere on the body. However, about 65 per cent affect the face.
Treatment Children with port wine stains should be referred to specialist centres for laser treatment, although this is not usually considered until the child is at least six months old.
Laser treatment
Until the last decade, treatment for port wine stains consisted of camouflage make-up. Since the advent of laser treatment this type of birthmark can now be effectively reduced or removed, and experts at Great Ormond Street consider it to be the treatment of choice.
The treatment involves a laser beam penetrating the blood vessels in the path of the birthmark. This in turn destroys the blood supply to that part of the birthmark by selective thermolysing (or burning in a controlled way). After treatment there should be a noticeable improvement in the birthmark's appearance, and in some cases where the birthmark is superficial it may disappear completely. Depending on its size, depth and colour, most children will need between four and six treatments, which are usually done every four months.
If you are not keen on this choice of procedure there are cosmetic camouflage treatments offered by the Red Cross or GOSH.
Helpful advice
Babies and young children with birthmarks should have their birthmarks examined and diagnosed by the local paediatrician. Rare types may need to be seen by a specialist.
If you feel that a child's birthmark is not being properly treated or diagnosed, advise the child's parents to book an appointment with their local GP. They should then see a birthmark specialist as soon as possible.
Further information
* The Birthmark Support Group provides information and support for anyone of any age who has a birthmark, but particularly children and their family and carers. For helpful advice see their website www.birthmarksupportgroup.co.ukor the GOSH website www.gosh.nhs.uk
