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Birthmarks

They can be flat or raised, pink, red or blue in color. Ten out of 100 hundred babies have vascular birthmarks. The cause of birthmarks is unknown. Some birthmarks need to be treated while others go away on their own. The prescribed treatment will depend on the type of birthmark. However, lasers have been very beneficial in removing most types of birthmarks safely. Several laser treatment sessions are generally needed to successfully remove a birthmark. The number of sessions will depend on how dark and thick the birthmark is. Fortunately, vascular birthmarks are neither dangerous or malignant. If the hemangioma is close to the eye, glaucoma (high pressure of the eyeball) may occur in very rare cases, and consultation with an ophthalmologist may be necessary.

VASCULAR TUMORS AND MALFORMATIONS

Vascular tumors and malformations are often present at birth and therefore referred to as "birthmarks". The strawberry hemangioma is the most common type of vascular tumor whereas the most common types of vascular malformations are commonly called port wine stains and cavernous hemangiomas.

Strawberry Hemangiomas
Strawberry hemangiomas usually appear as a single lesion on the head or neck, although they can appear on the trunk and limbs. The shape and colour of these birthmarks are what gives the name strawberry hemangiomas. The hemangioma will grow as the child grows for the first year and then will gradually involute going from a bright red, raised, round lesion to a puckered gray, yellow patch. Once this occurs, most patients do not seek therapy. They may completely disappear without therapy.

Port Wine Hemangiomas
A port wine hemangioma is an abnormal collection or network of blood vessels present beneath a layer of otherwise normal skin. The dense network of vessels is the remainder of extra blood tissue that was present during the first month of embryonic life. A port wine hemangioma was so named because the skin appears as though a red, pink or purple liquid such as port wine has been poured over it. Port wine hemangiomas are present at birth and grow at the same rate as the normal surrounding skin. In the third, fourth, or fifth decades of life, a port wine hemangioma may become thicker or spongier than the adjacent normal skin and the surface of the hemangioma, which may have been quite smooth during the first decades of life, may develop an irregular and lumpy appearance.

Cavernous Hemangiomas
A cavernous hemangioma may be characterized by tumor-like networks of dilated blood vessels and/or irregularly shaped, thin-walled spaces that may permeate organ systems. Cavernous hemangiomas appear during childhood and will grow proportionally as the child grows. They can vary greatly in size and are usually under the skin. When they are elevated above the surface of the skin they may appear to be nodular and bluish purple in color. When compressed these lesions will often empty of blood then rapidly refill. There are several sub categories of cavernous hemangiomas.

What treatments are available for vascular birthmarks?
Most forms of past therapies on hemangiomas have been abandoned because they are either ineffective or because they create another deformity that is as undesirable as the hemangioma itself. Surgeons have removed port wine hemangiomas and reconstructed the area with skin grafts.

Such procedures entail a significant amount of surgery, and the scars that result are often quite unacceptable. X-rays, which were used in the past, are now known to be potentially dangerous and are no longer used to treat port wine hemangiomas. A variety of agents have been injected into the involved skin but with no significant success. Liquid nitrogen and the carbon dioxide laser have also been used and proven to be ineffective. Tattooing has been attempted on hemangiomas, but the results are temporary, and merely camouflage the birthmark. The best available treatment options are the use of lasers which target the vasculature in the skin, such as the pulsed dye lasers.

How do the vascular removal lasers work?
These lasers generate a very powerful light. Laser light produces an enormous amount of energy, which may be finely focused. The laser light passes harmlessly through the top layer of skin as the laser hits the red color of the birthmark and the light is absorbed and its energy released as heat. The heat breaks, coagulates or cauterizes the small vessels under the skin. The intense heat produced by the reaction to the laser light may cause a bruise and/or swelling, which gradually disappears. It may require a number of sessions to reach all the layers of a hemangioma. Scar and irregular pigmentation is possible but exceedingly uncommon.

 

Definition:
Most birthmarks are made of blood vessels bunched together in the skin.


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