Infantile hemangiomas also called strawberry birthmarks, are one of the most common skin growths seen in infancy. They are a noncancerous overgrowth of extra blood vessels. The spots generally appear as a red patch in the skin that will grow to a red raised area over a short time.
Infantile Hemangiomas (strawberry birthmarks)
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, babies with a low birth weight, and multiple births.
Generally, this type of birthmark is a vascular tumor, a red patch or bump is present at or shortly after birth. In the first months of life, up to a year of age, the spots usually grow considerably in size. The hemangioma becomes larger and darker red.
During this time, the growth phase is known as the proliferative phase. Rarely infants may have more than one of these growths present. They can also develop virtually anywhere on the skin.
Superficial and Deep Hemangiomas
These types of hemangiomas have some characteristics that can be unique or have mixed features. Superficial Hemangiomas often appear raised, not skin-colored, and bright red. Deep hemangiomas, also called subcutaneous hemangiomas appear bluish-hued.
The best dermatologists in Omaha know that several complications can occur from hemangiomas.
Ulceration
The most common complication is ulceration. Ulcerations can occur in hemangiomas anywhere on the body. In these cases, the hemangioma grows rapidly and outgrows its blood supply. The overlying skin breaks down leaving an open sore.
The primary side effect is that this skin wound can become infected and very painful for babies. Surprisingly, despite their bright red color, substantial bleeding is not something we see as a complication when it comes to hemangiomas.
Head & Neck Area
Based on the location of the hemangioma, we can encounter other more serious complications. When hemangiomas are on a baby’s head or neck, we are concerned about them being near important structures. This is due to the rapid growth in the first year of life. Here are some examples:
- Hemangiomas on eyelids: Rapid growth can block the child’s vision. Rarely a hemangioma could cause permanent issues with eyesight.
- Hemangiomas on the lips or around the nose: These 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 regarding this common issue.
Involution Phase
First and foremost, after hemangiomas have completed the proliferative phase, they move into a new phase. During this phase, they gradually shrink and eventually disappear in most cases.
Sometimes after they have completed shrinking up, some 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 years.
General rules for this involution phase:
- By age 5, roughly 50% of hemangiomas disappear
- At around 7 years of age, roughly 70% of them disappear
- At age 9, roughly 90% will have disappeared.
Treatment Options For Infantile Hemangiomas (strawberry birthmarks)
Equally important, treatment options are available for cases where complications or significant worry about potential complications is present. The most important aspect of strawberry marks treatment generally involves actively treating a hemangioma during the proliferative growth phase. The goal is to keep them from growing as much as possible until this phase has ended.
At our clinic, we prefer to see infantile hemangiomas diagnosed and seen as early as possible, ideally by one month of age. By doing this, 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, the use of medications, known as beta-blockers has come to the forefront in dermatology.
Beta-blockers show great promise for the treatment of hemangiomas. In most cases, doctors administer these treatments systemically as a liquid medicine by mouth. However, they can also be applied topically to the growths.
Laser Treatments
Doctors may also use laser treatment in some cases with very thin or superficial hemangiomas. The best type of laser therapy for this is 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.
