Microincision
Face Lift
& Brow Lift
Treatment
of Birth marks
What
is a Vascular Birthmark?
Many babies have what are called "birthmarks" when they're born.
In some cases they may appear within the first few weeks of life. They
can be brown, tan, blue, pink, or red. More than 10 in 100 babies have
vascular birthmarks. These are made up of blood vessels bunched together
in the skin. They can be flat or raised, pink, red or bluish discolorations.
What
Causes Birthmarks?
Why do vascular birthmarks occur? As with many other birth defects, the
exact causes are unknown. Most vascular birthmarks are not inherited,
nor are they caused by anything that happens to the mother during pregnancy.
What
are the Different Types of Vascular Birthmarks?
There are different kinds of vascular birthmarks. Sometimes, the birthmark
must be watched for several weeks or months before the specific type can
be identified. The most common types of vascular birthmarks are macular
stains, hemangiomas, and port-wine stains. There are also many rare types
of vascular birthmarks.
Macular
Stains
Your physician will call faint, mild red marks macular stains. They are
the most common type of vascular birthmarks. They are also called "angel's
kisses," when they are located on the forehead or eyelids. When they're
found on the back of the neck, they're called "stork bites."
They may also occur on the tip of the nose, upper lip or any other body
location. They are pink and flat. Angel's kisses almost always go away
by age two, but stork bites usually last into adulthood. These birthmarks
are harmless and require no treatment.
Hemangiomas
The term "hemangioma" is used to describe many different kinds
of blood vessel growths. Most dermatologists prefer to use hemangioma
to refer to a common type of vascular birthmark. These marks do not usually
appear immediately after birth, but become visible within the first few
weeks of life. Hemangiomas are usually divided into two types: strawberry
hemangiomas and cavernous hemangiomas.
A strawberry hemangioma is slightly raised, and bright red because the
abnormal blood vessels are very close to the surface of the skin.
Cavernous hemangiomas have a blue color. That's because the abnormal vessels
are deeper under the skin. Hemangiomas are more common in females and
in premature babies. They can be anywhere on the face or body.
Usually, a child will have only one hemangioma, but sometimes there will
be two or three. In rare cases, an infant may have many, or even some
internally. Unlike other vascular birthmarks, hemangiomas can grow very
rapidly. Growth generally begins during the first six weeks of life and
continues for about one year. Most never get bigger than two or three
inches in diameter, but some may be larger. After the first year, most
hemangiomas will stop growing. They then
begin
to turn white and slowly shrink. Half of all hemangiomas are flat by age
five; nine out of ten are flat by age nine. Many will completely go away,
but often, a faint mark is left.
It's impossible to know how big any hemangioma will grow, or if it will
completely disappear.
Complications
of Hemangiomas
Occasionally, a hemangioma that's growing or shrinking rapidly can form
an open sore or ulcer. These sores can be painful, and can become infected.
It's very important to see your dermatologist and keep this sore clean
and covered with antibiotic ointment and/or a dressing.
A hemangioma located over the female genitals or rectum, or near an eye,
the nose or mouth, can cause special problems. These hemangiomas should
be watched closely by your dermatologist who will decide if further treatment
is necessary.
Parents are often concerned that a hemangioma will bleed. These birthmarks
do look as if they could bleed easily. However, this usually isn't a problem.
Bleeding usually occurs only after injury. If the hemangioma starts to
bleed, it should be treated like any other injury - clean the area with
soap and water or hydrogen peroxide and apply a gauze bandage. Apply firm,
but not tight, pressure on the area for five to ten minutes. If the bleeding
has not stopped, call your doctor.
A hemangioma will rarely grow suddenly over one or two days. If this occurs,
it's important to call your dermatologist. Also, if a bruise begins to
develop, your dermatologist should be notified.
Treatment
of Hemangiomas
It's very important that a baby with a vascular birthmark be examined
by a dermatologist as early as possible, so that a correct diagnosis can
be made and the need for treatment discussed. It's not always easy for
parents to watch a hemangioma grow, or wait for it to disappear, without
doing anything. However, most hemangiomas do not require treatment. They
eventually shrink by themselves, leaving very few signs.
There are several different types of treatments for hemangiomas that need
care. No treatment is absolutely safe and effective. The potential benefits
must be weighed against the possible risks.
The most widely used treatment for rapidly growing hemangiomas is corticosteroid
medication. This is either injected or given by mouth. Long-term or
repeated treatment may be necessary. Some of the risks of therapy include
poor growth, elevated blood sugar and blood pressure, cataracts and an
increased chance of infection.
Lasers can be used to prevent growth of hemangiomas. Most lasers can only
penetrate deep enough to treat surface hemangiomas. However, there is
a laser that may treat deeper components but it's not readily available.
Hemangiomas with sores that will not heal can also be treated with lasers.
Laser treatment is costly and there are risks. They include pain, ulceration,
and, in rare cases, scarring. There may be some risks and other costs
if general anesthesia is needed.
Many other treatments have been tried and new experimental treatments
are being studied. In most cases the best results are to let the hemangioma
go away slowly on its own.
Port-Wine
Stains
The port-wine stain is another type of vascular birthmark that occurs
in 3 in 1,000 infants. It is sometimes called a nerusflammeus, or capillary
hemangioma, but it should not be confused with a hemangioma.
Port-wine stains appear at birth. They are flat, pink, red or purplish
discolorations, found most often on the face, neck, arms or legs. They
can be any size. Unlike hemangiomas, port-wine stains grow only as the
child grows. Over time, port-wine stains may become thick and develop
small bumps or ridges. Port wine stains do not go away by themselves,
but last a lifetime.
Complications
of Port-Wine Stains
The most common complications from port wine stains, especially those
on the face, are emotional, social, and economic. Even the smallest facial
port-wine stains may influence how you feel about your appearance, may
affect how others treat you and prevent you from getting certain jobs.
Port-wine stains on the forehead, eyelids or both sides of the face, can
be associated with I glaucoma, and/or seizures. Glaucoma is pressure within
the eye that, left untreated, can cause blindness. These complications
occur in less than one-fourth of those with port-wine stains of the forehead
and eyelids. All infants with a port-wine stain in those areas should
have a thorough ophthalmologic (eye) and neurologic examination.
Occasionally, there may be very gradual enlargement of tissues surrounding
a port-wine stain. All children with large port-wine stains involving
an arm or leg should be followed for any growth problems.
With time, port-wine stains can develop small blood vessel growths, called
pyogenicgranulomas.
These can bleed easily, and should be removed.
Treatment
of Port-Wine Stains
The use of cover-up makeup has been a common treatment for port-wine stains.
Your doctor can provide you with more information about products that
are made to cover up birthmarks.
Various methods have been tried in the past to remove port-wine stains,
but none have worked well. New types of lasers have shown the best results
with the least amount of risk and side effects.
Laser treatment of port-wine stains is FDA approved, and available at
several centers around the country. For best results, treatment should
begin as early as possible, even in infancy. Laser surgery is performed
on an outpatient basis. Several treatments are usually required, given
at two month intervals. Younger patients often require fewer treatments
than adults. In about one-fourth of the patients, lasers can totally clear
up the port-wine stain. Seventy percent will look much better. For reasons
that are not understood, a small number of patients will not respond well
to laser therapy.
There are several risks of laser therapy. An increase or decrease in skin
color can occur, leaving patchy tanning or whitening of the skin. In most
cases this is not permanent. Swelling, crusting or minor bleeding can
occur. This is unusual and can be treated easily. Permanent scarring has
happened, but is extremely rare. Laser therapy is uncomfortable, but not
extremely painful. Anesthesia is not required for most adults. However,
anesthesia is often important for toddlers and young children. If general
anesthesia (putting the child to sleep) is required, there are some risks
and higher costs.
Most vascular birthmarks disappear without treatment or can be treated
effectively. Through research, we're learning more about the causes and
treatments of all types of vascular birthmarks.
