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.

Hemangiomas are a particular type of vascular birthmark.

What Causes Birthmarks?
Why do vascular birthmarks occur? 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.

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 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 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 both prevent growth of hemangiomas and remove hemangiomas. Hemangiomas with sores that will not heal can also be treated with lasers. New lasers are being developed and studied by dermatologists to treat this condition.
(modified from AAD Hemangioma Information)

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