When Are Birthmarks a Cause for Concern?
Hemangiomas generally disappear
gradually on their own
An interview with dermatologist
Lucia Tuffanelli, M.D., board certified dermatologist
You’ve brought your perfect infant home from the hospital. Her beautiful, soft skin is a delight to behold. After about two weeks, you notice a small reddish bump on her face. The bump doesn’t seem to cause discomfort, but as it continues to grow, you consult your pediatrician. The diagnosis? It’s a hemangioma (pronounced hee-man-jee-oh-muh).
“A hemangioma is basically an abnormal
buildup of blood vessels under the surface of
the skin,” says Lucia Tuffanelli, M.D., a dermatologist
at California Pacific Medical Center.
“The most common type is called a ‘strawberry’
hemangioma because it has a bright red color
and a well-defined border. Strawberry hemangiomas
are right beneath the surface of the
skin. A ‘cavernous’ hemangioma is a larger collection
of blood vessels deeper beneath the
skin. Cavernous hemangiomas generally appear
as a bluish-red blotch. Both types may be present
at birth, but usually they develop within the
first month of life. The most common sites are
on the head, neck and torso.”
Rapid Growth, Gradual Disappearance
Tuffanelli notes that strawberry and cavernous
hemangiomas tend to grow rapidly for the first
six months and usually don’t grow any more
after 12 months. “After the first year, most
hemangiomas start to fade and go away on
their own. By age 9, almost all strawberry
hemangiomas go away completely. Cavernous
hemangiomas also go away, but in a few cases
they may leave a trace of discoloration. Fewer
than 10 percent require treatment.”
Rare cases that might require treatment—
which often consists of laser therapy—include
hemangiomas that grow very rapidly near the
eyes, ears, nose or mouth, where they can
obstruct vision, hearing, breathing or eating.
“Hemangiomas that develop ulcerations, crusting,
infections or bleeding also may require
treatment,” Tuffanelli adds.
Some Birthmarks Need Treatment
While strawberry and cavernous hemangiomas
generally appear weeks after birth, some birthmarks
are present at birth. “About 40 percent of
newborns are born with a ‘salmon patch’—a
pinkish or salmon-colored blotch that usually
appears on the face or the back of the neck,”
Tuffanelli explains. “The ones on the back of
the neck are often called ‘stork bites’—referring
to the story that storks deliver babies. Most
salmon patches fade significantly and are not a
cause for concern.”
A more prominent birthmark, the port-wine
stain, is a darker reddish-purple color and is
slightly elevated. “Port-wine stains usually
occur on the face, and they don’t fade with age,”
Tuffanelli says. “Because they can be disfiguring,
we generally would consider laser therapy
or other treatments.”
Any parent who notices a hemangioma or
other birthmark should consult his or her pediatrician
and perhaps a dermatologist.
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