Birthmarks are common skin lesions that can occur approximately in 1/200 births. They can be present at birth or can present during the first year of life. To oversimplify, birthmarks can be categorized as red (vascular birthmarks) which come from some form of vascular proliferation or malformations; or brown (pigmented birthmarks) which arise from pigment producing cells called melanocytes.
The two most common vascular birthmarks are hemangiomas and port-wine stains. Hemangiomas can be present at birth or appear within the first few months of life. They will often get bigger within the first year and then slowly resolve at anytime over the next 9 years. A rough rule of thumb is 10% will resolve by 1 year old, 20% by 2 years old, 30% by 3 years old, and so on. By the time children reach kindergarten, about 50% will be resolved. Less commonly, complications such as ulceration, scarring, and functional impairment can occur pending the severity and location of the hemangioma. Laser therapy is available to help stimulate the resolution of hemangiomas. This involves a laser called a pulsed-dye laser which selectively heats the blood vessels while avoiding damage to the surrounding tissue. Hemangioma treatment can begin as early as a week or two old with little discomfort to the infant. No anesthesia is needed. Treatments will usually continue on an every 3-4 week schedule until resolution is complete or near complete.
Port wine stains are different from hemangiomas due to the fact that they are permanent and will not resolve with time. In fact, port wine stains will progress, thickening and sometimes resulting in continued growth of the underlying tissue (i.e. increased limb length or thickness, facial asymmetry, nodules that can bleed with slight trauma). Laser treatments using the pulsed-dye laser is the standard of care. Multiple treatments every 3-4 weeks as early as possible allows for the best chance for complete removal. Even if complete removal of port wine stains is not possible, improvement almost always takes place and will decrease the chances for long-term complications.
Pigment (brown) birthmarks come in many different sizes and require a different set of lasers that target pigment rather than blood vessels.
Not all birthmarks are recommended for treatment. See the dermatologist at Skin Wellness Physicians for a consultation to determine the best treatment.