Birthmarks

Hemangiomas are vascular birthmarks or made of blood vessels. They may appear blue, red or purple in color and grow in many shapes and sizes. These are growths of blood vessels and may be found on the surface of the skin where they appear more red or deeper in the skin where they appear more light blue. They can grow rapidly in the first few months of life. It’s important to diagnose and treat early for certain types which may develop painful sores and infections. The dermatologists at AdventHealth for Children can determine if your child's birthmark is a hemangioma.

Port-wine stains are flat pink-red marks on the skin present at birth and then turn a darker red- purple throughout life. They can be small in size or cover a large portion of the body.

Nevis simplex, also called Salmon patches, stork bites, angel kisses and macular stains, are lesions appear as thin, flat, light pink patches on the skin. They usually appear on the back of the scalp, the upper eyelids, the upper lip, or between the eyebrows.

Congenital moles are usually brown in color, vary in shape and size, and can appear anywhere on the body.

Café-au-lait macules range in color from light brown to chocolate brown smooth, flat marks on the skin. These usually appear on the torso, buttocks and legs.

Every birthmark should be examined by a doctor to determine what type of birthmark it is and what complications may arise from it. Just as there are different types of birthmarks, these different lesions may have different complications. Hemangiomas may develop open sores that can get infected. This can be extremely painful for your child. Pigmented birthmarks rarely cause other problems, however require monitoring throughout life for changes in size, color, or texture, which may be normal or could be more worrisome

Most pigmented birthmarks such as Mongolian spots or café au lait macules do not require any treatment however occasionally nevi or moles may require intervention. Giant or Large congenital nevi should be monitored and may require surgical intervention depending on location and size. A dermatologist can help determine if a lesion needs any intervention.

There are many treatment options for vascular birthmarks, especially hemangiomas and port wine stains but, many of these treatments should be started as early as possible. Other vascular birthmarks such as salmon patches or nevus simplex do not require intervention as many of these lesions fade with in the first few years of life. Our team can help determine which type of birthmark your child has and the treatment options available.

Lasers are the treatment of choice for port-wine stains. Most lighten significantly after several treatments with a pulsed-dye laser, although some may return and may require more treatment. Laser treatment is often started in infancy when the port wine stain and the blood vessels are smaller, but our team can assess your child's individual situation and recommend treatment no matter their age. Special opaque makeup also can camouflage a port-wine stain.

Hemangiomas can be treated multiple different ways including with topical creams, medications by mouth or lasers. For many lesions especially ones affecting the face, we may use multiple treatments in conjunction. Since these grow rapidly during infancy, treatment should be started early to prevent growth and any disfiguring complications.

This will depend on how large the lesion is and on the location. But the majority of patients with hemangiomas may go through 6-8 treatments whereas a port wine stain may require many more. Treatment for a port wine stain may be broken up over months to years. Often times, your dermatologist may start treatment when the child is young but may choose to continue with treatment when they are older and have a better understanding of the procedure.

Yes, most of the laser treatments may be done in the office. However, occasionally children may have large lesions that cannot be treated in the office. Some of these patients may require anesthesia to treat. We have several children that we treat in the hospital with an anesthesiologist.

The day of the laser treatment and maybe a few days after, the lesion will appear as a deeper shade of purple. This is because we are targeting blood vessels with the laser and when we destroy them, there are small bruises left behind. The child may have some sensitivity in the area for one to two days (almost like a sunburn).