The following guest post is by Andre Panossian, MD. Dr. Panossian is a Board-Certified, Pediatric Plastic & Reconstructive Surgeon based in Los Angeles, CA, specializing in correcting facial paralysis, large vascular birthmarks (hemangiomas), burn/accident wounds, webbed fingers/feet, cleft lip and palates and more. He frequently volunteers for international medical missions Mending Kids International and Operation Smile. Learn more about Dr. Panossian at DrPanossian.com, or connect with him directly on Twitter or Facebook. (Dr. Panossian is married to Right Start Mom Jill Simonian.)
“Doctor! My baby suddenly has this big, raised birthmark thing that popped up on her neck… what the heck is this? Can we take it off?” I must get dozens of questions like this through my office (or, just in passing with friends and acquaintances) on a monthly basis.
The parents usually seem scared.
As a dad, I know that feeling of fear (don’t tell my wife). As a pediatric plastic surgeon, I can confidently tell you that that big, raised “birthmark thing” is called a hemangioma. Don’t be intimidated by the word or appearance. I treat them all the time. I can tell you (as a surgeon): Hemangioma are not as scary they seem.
Hemangiomas are large, red(ish) birthmarks that can show up in the first few weeks of life and can enlarge for up to 10-14 months. They’re harmless tumors consisting of a bunch of blood vessels clumped together in the skin and fat layers. They go by many names, such as “strawberry mark” or “vascular birthmark.” They usually don’t appear immediately at birth (as many parents know from experience), but seeing one develop can be intimidating and concerning. If I saw one for the very first time on one of my daughters (and wasn’t educated about what it was), I’d be concerned, too.
Fear not… hemangiomas are universally benign and are likely to shrink and fade on their own usually by the time children reach 5 years old.
Parents often ask me: Why did this happen? After years and years of study, we still really don’t know why these funny birthmarks pop up. There are many scientific theories (which I won’t get into here), but we do know the following that might ease your worries: 1) They are not hereditary, 2) They are not the result of exposure to something toxic during pregnancy and 3) They do not become cancerous — nor do they spread like cancer or indicate any kind of underlying serious health problem in most cases. Good news, right?
What can parents do? Get a proper diagnosis. As simple as this sounds, it’s sometimes tricky. While more than 90% of hemangioma cases can be identified on appearance alone (preferably by a board-certified pediatric plastic surgeon), other similar birthmarks may be mistaken for a hemangioma, such as a “Cupid’s kiss” (a red mark that appears over the forehead or a “stork bite” on the nape of the neck… my daughters each had stork bites when they were born). These are also harmless, but are starkly different in appearance and will not follow the same life cycle of a true hemangioma (which is why you really should have a specialist check it out so you know what you’re dealing with from the beginning).
After getting the diagnosis right, the next step is deciding on a plan of action. What to do if it gets too big? What if it bleeds? What if the skin swells or breaks down and flakes off? Don’t panic… these are all “what-ifs.” Most hemangiomas can be observed until they spontaneously disappear over several years (even for large ones that are located on the chest, belly, scalp, arms or legs). But what if it’s on your child’s face and pushing on her eye? Well, you do have the option for removing it, and there are pros and cons. My own personal philosophy (generally speaking) is that removing it is only necessary when it obstructs your child’s vision or some other key function, or if it is causing some type of disfigurement (another option is to inquire with your specialist about the facts surrounding the medication propranolol – an adult medication for blood pressure – that has been discovered within the last several years to effectively control the growth of hemangioma in the first year of life). However, if the hemangioma is not inhibiting your child’s quality of life, I most often recommend leaving it alone.
My biggest message to you, as a surgeon who happens to be a dad of two little girls: Know that you’re not alone, and know that these birthmarks are not dangerous. One in 10 children born will eventually have a hemangioma — this is quite common. It’s also important to remember, for your own peace of mind, that nothing was “done wrong” during pregnancy nor are hemangioma related to genetics. Never hesitate to meet and question a specialist to calm your fears.
And, speaking for myself, if you happen to find a specialist who also happens to be a parent, know that that doctor has an extra-soft spot when it comes to caring for kids.
If you are interested in learning more about hemangiomas, vascular birthmarks and more, Dr. Panossian has posted a wealth of in-depth information here.