Birthmarks & Hemangiomas in Children: Types, Causes & Treatment


We always look forward to giving birth to healthy kids with a beautiful appearance. However, what happens when you notice your newborn has a birthmark? It could be one of the expectations, but you cannot predict where it will appear and what size and form it will take. Some can be disregarded if they don’t cause any harm, but embarrassing ones need some action taken.

In this guideline, we will focus on the following:

  • What are birthmarks?
  • What causes birthmarks?
  • Types of birthmarks
  • How to treat birthmarks
  • When do you need to call the doctor?

What Are Birthmarks?Birthmarks

When you give birth to a newborn, you may notice some temporary blotches or pimples that go away shortly after delivery. It could be days or weeks. Birthmarks may also appear on their skin soon after birth. While that briefly answers the question of when do babies get moles and birthmarks, we also need to know more about the marks that you can either hardly notice or they appear disfigured. Why? Because they are not always the best thing to look at no matter how small or big they resemble.

These ‘scars’ have no specific structure or color. They can be raised or flat, and apart from the red birthmarks on baby’s face, they can acquire other varying shades such as purple, black, pale blue, tan, pink and brown. One more thing, they can have a regular border or an irregular one.

In most scenarios, they are harmless as the baby grows and may disappear or shrink as time progresses. However, babies born with birthmarks could also have other underlying health conditions which makes it a vital decision to keep the doctor close to the matter.

What Causes Birthmarks?

what cause Birthmarks

Now that you know what they are, the next question is why do babies get birthmarks? There are no preventive measures to stop them from occurring, and their origin is never about something done or was not done. So, the old wives’ tales are just stories since science has not given us an answer yet.

Inheritance might play a key role, but it is not the usual case. There is also no relation between birthmarks and traumatizing the skin during delivery. So, researchers are still digging deeper to see what causes birthmarks in babies.

Is there any relationship between birthmarks and early birth?

Researchers have gone ahead to investigate if premature infants are at a higher risk of having strawberry birthmarks than those born within the right duration. Findings from The Medical College of Wisconsin showed that cases of low birth weight were more vulnerable to the development of premature hemangiomas – benign angioma composed of blood vessels groupings where some could result to birthmarks.

There are other known risk factors that the study recognized regardless of its primary motive. According to the leading physician, they include prematurity, female gender, and the white ethnicity. Getting the link to having low birth weight could help explain why the researchers believe that it can be the reason why newborns are contracting hemangiomas. Based on the statistics from low birth weight analysis, it is estimated that cases of premature hemangiomas have increased by 40% in a period of 20 years.

Possible causes of strawberry birthmarks

Now, what about the infants born with normal birth weight but still get birthmarks? In another study published in the Pediatric Dermatology Journal, the report showed that oxygen disturbance in the placenta during gestation period resulted in premature hemangioma. Interrupting the placental circulation mode is a significant factor towards the development of infantile birthmarks in exceedingly low birth weight infants according to the researchers.

Such a conclusion gives the drive towards investigating the placenta to see if any physiological changes lead to strawberry birthmarks in babies born with the appropriate weight range.

With such reports that don’t show any defined observations, the only thing that remains is looking for more answers. Still, there is no known medication, food intake or activity that can cause their occurrence during pregnancy. So, if you are feeling guilty about something related to any of the above mythical aspects, it’s time to stop worrying. Another thing worth mentioning is that strawberry birthmarks tend to go fade out at random. Like we said earlier, they are painless and harmless, but statistics report that one out of a hundred victims needs medical attention at some point. So, it is essential that you talk to the doctor to evaluate the situation before determining whether you can relax or go for another appointment. We will discuss the strawberry birthmarks in detail in the types section.

5 Types of Birthmarks

They are two major categories:

  • Vascular birthmarks:They are formed by blood vessels that don’t have the correct formation. They are either too many on one part or sparse than the usual range.
  • Pigmented birthmarks:They form as a result of cells overgrowth which causes a pigment in the skin.

Pigmented birthmarks

They are also known as moles or nevi. In case you are wondering when do babies get moles and birthmarks eventually, the infant can acquire them later after birth or they could be present during delivery. The cells that make this type of birthmark are known as nevus cells and are either black or dark brown in color.

Now that you are aware of what are pigmented birthmarks let us focus on the two possible ways that they can occur.

Congenital Nevi (Present at birth)

What you will mostly see are the small nevi whose diameter are not more than three inches. They are there during delivery and statistics portray that they occur in an average of one out of every 100 born infants. Their main characteristic is that they continue to grow as the child progresses and will not cause any issues in most cases. On the other hand, the moles may go on to reveal severe cancerous form on the skin known as melanoma.

So, you may not worry in the meantime, but it is advisable you do to the doctor to exclude any possibilities of cancer development. The pediatrician will regularly check for changes in size, shape, and color. If anything is leading to removal, the specialist will refer you to a dermatologist for retrieval and aftercare.

A more severe form of nevus that is also congenital has varying sizes which range from three inches to the size of an A4 book. Their appearance could be raised or flat, and at times, you may find hair growing on it. The largeness of this kind of nevus could cover a whole arm or face for example.

What makes researchers and parents breathe is that such large birthmarks are rare with reports showing that they occur in one out of every 20,000 newborns. However, the child is more likely to develop melanoma when compared to the small forms, so it becomes necessary to consult a physician.

Acquired moles or nevi

If you are of the Caucasian origin, there is a possibility of contracting 10-30 pigmented moles in your lifetime. The affected usually notice their formation as early as the age of five or even earlier. The acquired moles should rarely be a cause to worry. However, if your kid has one that has an irregular shape with more than one color and is bigger than one inch, call your specialist for evaluation.

To conclude on this matter, most of the acquired nevi on the skin are lentigines (freckles). You can notice them when your child is between 2-4 years old on the body areas often exposed to sunlight. They are also hereditary, so it is not a wonder to see them on your child if you already have them. During summer, the nevi may appear darker than usual or even larger, but the prominence will decrease during cold weather. Regardless of how they seem, it should not be a worrying cause when you see them in children.

Vascular birthmarks (Infant Hemangiomas)

Vascular birthmarks

Sometimes, you see red birthmarks on baby’s face or one of the arms as a red bump growing at a fast rate. They are not cute, but you could verify if they are harmful or not. Vascular birthmarks originate from an odd blood supply on a specific skin area of the fetus before you give birth. This eventually causes an enlargement of the affected tissue as the fetus grows in the womb to form a reddish-blue patch.

Now, when the occurrence involves the capillaries only, such a birthmark is known as a hemangioma of infancy or hemangioma. If larger blood vessels were at play, that results in something different maybe in type or appearance or both.

Flat Angiomata

The standard English word for it is stork bites. They are common blemishes that appear on the skin at the back of a child’s neck or eyelids. They go away after the first few months or years of child growth and are not a cause to worry.

Strawberry birthmarks (Hemangiomas of infancy)

Strawberry birthmarks

Yes, this is what we call the strawberry birthmarks in case introducing it before created some confusion. Reports show that about two in every 100 newborns get these patches. You may not notice anything after delivery only to appear later after the second month for example as a raised dot or reddish spot. They do not have a specific area of occurrence, but common areas are the trunk, head, and neck. In normal circumstances, the kid might have only one instance of hemangioma, but other scenarios portray marks scattered in several body parts.

When your bundle of joy grows a hemangioma, have it checked to determine its cause. Hemangiomas usually continue to multiply until the infant attains six months. This can be a reason to raise the alarm, but they soon decrease the rate of expansion afterward and go on to flatten or disappear by the time he or she is about eight years old.

Now, as a parent, you may get irritated by seeing large reddish patches on your kid’s face especially if it wasn’t among your expectations. So, you will go to the best pediatrician and dermatologist to seek its removal. On the other hand, the majority of birthmarks occurring during childhood will slowly reduce their size over the years so why not leave them alone? The specialists’ advice is that if you leave hemangioma untreated, it will result in less cosmetic hitches and other related complications.

Conditions that may deem it necessary to remove the strawberry birthmarks include:

  • When they appear closer to vital organs or body parts like the mouth, eyes or throat.
  • If they are growing at an alarmingly rapid rate.
  • If there is a higher risk of future infections or bleeding copiously.

It is not common for you and the kid to arrive at such a situation but when it comes to any of the three scenarios, consult the pediatrician and the associated dermatologist on the way forward. In other cases, strawberry birthmarks formation on the face demand removal while the child is still in the infant stage to counter the social stigma pressure plus the scars will be minor at this point of the young one’s life. Regardless of the pushing factor towards total removal, the decision has to involve the pediatrician, a pediatric dermatologist and the surgeon who will conduct the plastic surgery.

It is only in sporadic cases that you will see a large birthmark concentration on the face or upper part of the trunk. That brings in the possibility of these patches being on organs inside the body. If this is what you are suspecting after analysis with the pediatrician, further testing will be necessary after an agreeable conclusion.

Port wine stains

They are flat deformities that happen in small blood vessels and are usually present when the baby is born. Port wines are dark red in color, and you will see them on the face or sometimes the limbs. They are either on the left or right side of the body, and they can occur anywhere apart from the named parts.

Once they appear, it is not easy for them to go away like the hemangiomas. They might fade but will still stick around. Port wine is not harmful, but if it occurs somewhere such as the forehead or upper part of the eyelid, it could be a sign of brain structure complication known as Sturge-Weber syndrome. Also, if it occurs anywhere around the eye, the kid might be facing glaucoma.

Just like the rest of the birthmarks, you need to regularly check where it is, size and how it looks like. If your child does not like the birthmark especially if it is around the face, you can use a special makeup to cover it. For removal, laser treatment has proved to be successful.

How to Treat Birthmarks

Removal and aftercare of most birthmarks are possible. For pigmented birthmarks, they are usually left alone. If it’s congenital, meaning present at birth, it is also removable. Large congenital moles can be surgically removed, but more than large proves to be difficult when removing.

Specialists can treat vascular birthmarks. If your child has a macular stain, it will fade away after some time. When it appears at the neck’s back, it can remain there quite longer than in other areas but will disappear in such a way it’s hard to notice.

Port wines and some forms of hemangiomas can be embarrassing for the children. For hemangiomas, they will eventually shrink by the time your child is ten years old, but larger ones will need treatment and medication.

Most port wines are removed using laser surgery. After several procedures, most of them appear to lighten when the pulsed-dye laser is used. If it returns, and they usually do, you will need another appointment. Laser options benefit the kid when they are at infant stage since the blood vessels are still small. Marks present on the neck or head tend to obey the laser removal methods. The below video express the visual guide to baby birthmarks.

Taking care of your child while at home

  • If the child has undergone treatment, make sure they take medicine as prescribed. Any other details that the doctor specifies also need to be followed.
  • Refrain the kid from scratching the birthmark especially if it is raised. It has blood vessels in it that can bleed when frequently disturbed. In case they bleed, cover the part with a pad and hold for some time to stop the bleeding.
  • It is a good practice to keep the child’s nails short. This will further prevent further damage to the birthmark.
  • Talk to your child about it. Make them understand that it is something natural. They will be at ease if you are.
  • You can use various hairstyles or makeup to cover it.
  • You can have the child talk to a counselor about it if they are still bothered by the birthmark.

When Do You Need To Call The Doctor?

time to call the doctor

First, the physician needs to check the birthmark when it appears for the first time. After this, he or she will determine the way forward and the best practice when it comes to monitoring.

If the birthmark bleeds, itches or contains an infection, it is essential that you call the doctor right away. When bleeding, treat it just like a typical injury by cleaning it up and applying pressure after placing a gauze bandage. If the bleeding persists, contact the physician.

Sometimes, hemangiomas can contract open sores and bring an infection. For the pigmented ones, they rarely cause any problems though they need time to time checking to see if they are normal or it’s another case of cancerous cells.

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