About one in 10 infants develops a vascular birthmark at birth or soon after. Though typically harmless, some may need treatment because of location and growth patterns, a dermatologist suggests.
“There are several different types of birthmarks, so it is important to determine the type of birthmark before considering any possible treatments,” dermatologist Dr. Sheila Fallon Friedlander, a professor of clinical pediatrics and medicine at the University of California San Diego, said in a news release from the American Academy of Dermatology.
“Most birthmarks pose no risks to infants and are best left untreated,” she noted, “but some can grow and potentially cause complications, particularly if they occur around the eyes, lips, nose or groin area. In addition, any lesion that has the potential to ulcerate should be monitored.”
Friedlander was scheduled to discuss the issue this week in New Orleans at the annual meeting of the American Academy of Dermatology.
Birthmarks are typically red, white or brown, noted Friedlander, who is also section chief of pediatric dermatology at Rady Children’s Hospital in San Diego.
Among the red variety, “infantile hemangiomas” are the most common, and typically take the form of a strawberry-shaped small bump or flat spot. Though they can grow through the first six months of life, dermatologists can usually assess ultimate size by the third or fourth month.
“Over time, most infantile hemangiomas will disappear on their own, but there are instances where dermatologists will recommend treatment,” she noted. “For example, if an infantile hemangioma occurs around the eyes, it can obstruct and prevent normal visual development if left untreated, or, if they occur in the groin area, they can become inflamed and then cause pain to the child.”
The use of propranolol, a drug used to treat high blood pressure, is considered a recent breakthrough in preventing and shrinking hemangiomas. However, the medication needs to be closely monitored because of potential side effects, Friedlander said.
“Depending on their size,” she added, “some facial birthmarks may leave behind a scar or saggy skin after they disappear. That is why it is often important for parents to consult a dermatologist as soon as their baby develops a birthmark, so it can be properly evaluated to determine if treatment is necessary.”
Friedlander further noted that in certain instances a large birthmark of this kind can indicate a serious health issue known as PHACES, which is associated with a risk for heart, eye, blood vessel and/or brain abnormalities.
So-called “port-wine stains,” which may slowly darken and thicken with time, are another physical and emotional concern, as they typically materialize on a child’s face and do not disappear on their own. Small brown moles, which carry a slight risk for developing into melanoma, can be an additional issue, as are white birthmarks which are generally harmless (aside from potential pigmentation complications) and far less common than the red variety.
Treatment depends on the type of birthmark, Friedlander noted, and steroids, oral and topical medications, surgical excision and laser therapy are all tools that a dermatologist can utilize to address birthmarks.
Alan Mozes
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