Infantile hemangiomas (strawberry birthmarks)

Infantile hemangiomas (strawberry birthmarks) are one of the most common skin growths seen in infancy.  They are a noncancerous overgrowth of blood vessels.  The spots generally appear as a red patch in the skin that will grow to a red raised area over a short period of time. Any infant may grow a hemangioma, but we know they are more common in certain circumstances.  The reasons for this are not clear.  Girls have them more commonly than boys.  They also occur more often in premature babies, or babies with a low birth weight.

Infantile hemangiomas (strawberry birthmarks)

With this type of birthmark generally we see a red patch or bump that is present at or shortly after birth.  In the first year of life, the spots usually can grow considerably in size becoming larger and darker red.  This time of growth for hemangiomas is called the proliferative phase. Rarely infants may have more than one of these growths present.  They can also develop virtually anywhere on the skin.

The best dermatologists in Omaha know that there are several complications that can occur from hemangiomas.

Ulceration

The most common complication is ulceration and can occur in hemangiomas anywhere on the body. With ulceration, the hemangioma grows so quickly that it outgrows its own blood supply and the overlying skin breaks down leaving an open sore. The primary problem with this is that this skin wound can become infected and can be very painful for babies.  Surprisingly, despite their red color, substantial bleeding as a complication is not something we see when it comes to hemangiomas.

Head & Neck Area

However, based on their location we can encounter other even more serious complications. Especially on the head and neck area we worry about hemangiomas on or near certain important structures, because due to the rapid growth in the first year of life sometimes they can interfere with these structures. One example is hemangiomas on eyelids. If these grow substantially and block vision, rarely a hemangioma could cause permanent issues with eyesight.  On the lips or around the nose a hemangioma may grow and block off the mouth/airway leading to breathing or eating issues.

Despite all these concerns, there are several pieces of good news when it comes to this very common growth.

Involution Phase

First and foremost, after hemangiomas have completed the proliferative phase, they then move into a phase where they gradually shrink and eventually disappear in most cases.  Sometimes after they have completed shrinking up, some a discoloration or scarring in the skin may remain.  The period of shrinking is called the involution phase for hemangiomas. This phase is much slower than the proliferative phase and can take a handful of years to fully occur.

There is a general rule for this involution phase:

  • By age 5, roughly 50% of hemangiomas disappear
  • By age 7, roughly 70% of them disappear
  • Age 9, roughly 90% will have disappeared.

Infantile hemangiomas (strawberry birthmarks) Treatments

Equally important, for cases where there are complications or we have significant worry about potential complications, we have treatments available to help. The most important aspect of treatment generally involves actively treating a hemangioma during the proliferative growth phase with the goal of keeping them from growing as much as possible until this phase has ended.

At Advanced Dermatology of the Midlands we prefer to see babies with hemangiomas as early as possible, ideally by 1 month of age.  This is so that we can assess the baby for potential complications and intervene with active treatment as early as possible when needed.

Medication

There are a few different medications that can be used to accomplish this. Traditionally prednisone had been the “go to” treatment. In recent years, use of medications in the category known as beta blockers has come to the forefront in dermatology showing great promise for treatment of hemangiomas. In most cases, these treatments are administered systemically as a liquid medicine by mouth. Sometimes they can also be applied topically to the growths.

Laser may also be used in some cases with very thin hemangiomas.  The best type of laser for this is known as a pulsed dye laser.  The pulsed dye laser we have available and use in our practice is the V beam perfecta.

Advanced Dermatology of the Midlands | Best Dermatologist Omaha & Council Bluffs, IA | Board Certified Dermatologists

Infantile hemangiomas are quite common, and they are something we see frequently in our clinics at Advanced Dermatology of the Midlands. We have extensive experience diagnosing and treating these growths. If you have a child affected by a hemangioma and would like any additional assistance, please contact us to schedule a consultation.