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Birthmarks - red

Strawberry mark; Vascular skin changes; Angioma cavernosum; Capillary hemangioma; Hemangioma simplex

 

Red birthmarks are skin markings created by blood vessels close to the skin surface. They develop before or shortly after birth.

Causes

 

There are 2 main categories of birthmarks:

  • Red birthmarks are made up of blood vessels close to the skin surface. These are called vascular birthmarks.
  • Pigmented birthmarks are areas in which the color of the birthmark is different from the color of the rest of the skin.

Hemangiomas are a common type of vascular birthmark. Their cause is unknown. Their color is caused by the growth of blood vessels at the site. Different types of hemangiomas include:

  • Strawberry hemangiomas (strawberry mark, nevus vascularis, capillary hemangioma, hemangioma simplex) may develop several weeks after birth. They may appear anywhere on the body, but are most often found on the neck and face. These areas consist of small blood vessels that are very close together.
  • Cavernous hemangiomas (angioma cavernosum, cavernoma) are similar to strawberry hemangiomas but they are deeper and may appear as a red-blue spongy area of tissue filled with blood.
  • Salmon patches (stork bites) are very common. Up to half of all newborns have them. They are small, pink, flat spots made up of small blood vessels that can be seen through the skin. They are most common on the forehead, eyelids, upper lip, between the eyebrows, and on the back of the neck. Salmon patches may be more noticeable when an infant cries or during temperature changes.
  • Port wine stains are flat hemangiomas made of expanded tiny blood vessels (capillaries). Port wine stains on the face may be associated with Sturge-Weber syndrome. They are most often located on the face. Their size varies from very small to over half of the body's surface.

 

Symptoms

 

The main symptoms of birthmarks include:

  • Marks on the skin that look like blood vessels
  • Skin rash or lesion that is red

 

Exams and Tests

 

A health care provider should examine all birthmarks. Diagnosis is based on how the birthmark looks.

Tests to confirm deeper birthmarks include:

  • Skin biopsy
  • CT scan
  • MRI of the area

 

Treatment

 

Many strawberry hemangiomas, cavernous hemangiomas, and salmon patches are temporary and do not need treatment.

Port wine stains may not need treatment unless they:

  • Affect your appearance
  • Cause emotional distress
  • Are painful
  • Change in size, shape, or color

Most permanent birthmarks are not treated before a child reaches school age or the birthmark is causing symptoms. Port wine stains on the face are an exception. They should be treated at a young age to prevent emotional and social problems. Laser surgery can be used to treat them.

Concealing cosmetics may hide permanent birthmarks.

Oral or injected cortisone may reduce the size of a hemangioma that is growing quickly and affecting vision or vital organs.

Other treatments for red birthmarks include:

  • Beta-blocker medicines
  • Freezing (cryotherapy)
  • Laser surgery
  • Surgical removal

 

Outlook (Prognosis)

 

Birthmarks rarely cause problems, other than changes in appearance. Many birthmarks go away on their own by the time a child reaches school age, but some are permanent. The following development patterns are typical for the different types of birthmarks:

  • Strawberry hemangiomas usually grow quickly and stay the same size. Then they go away. Most strawberry hemangiomas are gone by the time a child is 9 years old. However, there may be a slight change in color or puckering of the skin where the birthmark was.
  • Some cavernous hemangiomas go away on their own, usually as a child is about school age.
  • Salmon patches often fade as the infant grows. Patches on the back of the neck may not fade. They usually are not visible as hair grows.
  • Port wine stains are often permanent.

 

Possible Complications

 

The following complications can occur from birthmarks:

  • Emotional distress because of appearance
  • Discomfort or bleeding from vascular birthmarks (occasional)
  • Interference with vision or bodily functions
  • Scarring or complications after surgery to remove them

 

When to Contact a Medical Professional

 

Have your health care provider look at all birthmarks.

 

Prevention

 

There is no known way to prevent birthmarks.

 

 

References

Habif TP. Vascular tumors and malformations. In: Habif TP, ed. Clinical Dermatology. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 23.

Paller AS, Mancini AJ. Vascular disorders of infancy and childhood. In: Paller AS, Mancini AJ, eds. Hurwitz Clinical Pediatric Dermatology. 5th ed. Philadelphia, PA: Elsevier; 2016:chap 12.

Patterson JW. Vascular tumors. In: Patterson JW, ed. Weedon's Skin Pathology. 4th ed. Philadelphia, PA: Elsevier; 2016:chap 38.

 
  • Stork bite

    Stork bite - illustration

    A stork bite is a vascular lesion quite common in newborns consisting of one or more pale red patches of skin. Most often stork bites appear on the forehead, eyelids, tip of the nose, upper lip or back of the neck. They are usually gone within 18 months of birth.

    Stork bite

    illustration

  • Hemangioma on the face (nose)

    Hemangioma on the face (nose) - illustration

    Hemangiomas are tumors made up of dilated blood vessels that usually appear shortly after birth, although they may be present at birth. Hemangiomas on the face can be disfiguring and may interfere with visual development or cause obstruction of the airway.

    Hemangioma on the face (nose)

    illustration

  • Hemangioma on the chin

    Hemangioma on the chin - illustration

    This child has a juvenile hemangioma (strawberry hemangioma) on the chin. These may begin as flat, red spots and later become larger and elevated. Juvenile hemangiomas often go away (involute) spontaneously.

    Hemangioma on the chin

    illustration

    • Stork bite

      Stork bite - illustration

      A stork bite is a vascular lesion quite common in newborns consisting of one or more pale red patches of skin. Most often stork bites appear on the forehead, eyelids, tip of the nose, upper lip or back of the neck. They are usually gone within 18 months of birth.

      Stork bite

      illustration

    • Hemangioma on the face (nose)

      Hemangioma on the face (nose) - illustration

      Hemangiomas are tumors made up of dilated blood vessels that usually appear shortly after birth, although they may be present at birth. Hemangiomas on the face can be disfiguring and may interfere with visual development or cause obstruction of the airway.

      Hemangioma on the face (nose)

      illustration

    • Hemangioma on the chin

      Hemangioma on the chin - illustration

      This child has a juvenile hemangioma (strawberry hemangioma) on the chin. These may begin as flat, red spots and later become larger and elevated. Juvenile hemangiomas often go away (involute) spontaneously.

      Hemangioma on the chin

      illustration

    A Closer Look

     

      Self Care

       

        Tests for Birthmarks - red

         

           

          Review Date: 10/24/2016

          Reviewed By: David L. Swanson, MD, Vice Chair of Medical Dermatology, Associate Professor of Dermatology, Mayo Medical School, Scottsdale, AZ. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

          The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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