Vascular Birthmarks: When to Seek Treatment

One in 10 infants develops a vascular birthmark at birth or soon after. Most are completely harmless, but some may need treatment because of their location and growth patterns.

The three types of vascular birthmarks are stork bites or angel kisses, port wine stains and infantile hemangiomas.

Infantile hemangiomas typically start as flat to slight raised red to purple bumps at birth, but go through a rapid growth phase in the first 9 months of life and then slowly regress. Thirty percent are completely resolved by age 3, forty percent by age four, up to ninety percent by age nine. Over time, most infantile hemangiomas will disappear, but there are instances when treatment is recommended.

If there is involvement near the eyes, nose or mouth that may impair vision and or breathing then treatment is recommended. In the past steroids, lasers and surgery were used, but recently the use of propranolol, a drug used to treat high blood pressure, has shown success in preventing and shrinking hemangiomas. However, the medication needs to be closely monitored because of potential side effects.

Infantile Hemangiomas that grow to be quite large are at risk for ulcerating and may leave behind a scar or saggy skin that may never completely heal. In these cases treatment of the hemangioma may be warranted. Certain large hemagiomas may be associated with other health issues and increased risk of heart, eye, blood vessel and brain abnormalities.

Port-wine stains, flat red to purple colored patches of skin which may slowly darken and thicken with time, are another physical and emotional concern, as they typically materialize on a child's face and do not disappear on their own. Laser and surgical therapies may offer benefit in some cases.

Stork Bites, Angel Kisses or nevus flameus, as they are medically termed, are bright red patches of skin that may be present at birth or slightly after and are present in up to 30% of newborns. They may occur anywhere, but are most common on the face (angel kisses) or posterior scalp and neck (stork bites). Most of these fade completely within 2 years except for the stork bites on the posterior scalp and neck which may persist indefinitely.

In summary, most vascular birth marks are harmless and will fade on their own without any treatment. If there is any concern about the size, shape, or location of the birthmark please see your dermatologist to have the lesion evaluated.