Peds Derm Corner- Vascular Birthmarks October 3, 2017 By Advanced Dermatology Peds Derm Corner- Vascular Birthmarks- October Each month, Dr Swanson posts information about a common pediatric dermatology issue to educate patients and parents. This month, the topic is vascular birthmarks. What is a vascular birthmark? A vascular birthmark is a birthmark that is made up of blood vessels. The two most common types of vascular birthmarks are hemangiomas and port wine stains. What is a hemangioma? A hemangioma is a raised vascular birthmark that typically is not present when the baby is born. It develops in the first few weeks of life and initially looks just a little pink. With time it grows, becomes larger, and becomes more raised. They can be bright red (referred to as a strawberry hemangioma) or can be deeper and look blue. It is possible for it to be a combination and have a deeper blue component as well as a more classic strawberry component on top. They have the potential to grow until the child is 8-12 months old. Once they stop growing, they typically go away, but it can take up to 10 years to go away completely. They are benign (not dangerous), but can grow and cause issues depending on where they are and how big they are. How are hemangiomas treated? Most hemangiomas don’t need treatment. If a hemangioma is large or in an important location (eyelids, nose, lip, ear, genital area), then we will typically treat them. Propranolol is an oral medicine that works extremely well for hemangiomas. It shrinks them somewhat, but the main goal with propranolol is to prevent the hemangioma from growing. Propranolol is used in adults to reduce high blood pressure and we use much smaller doses in infants for hemangiomas. Side effects, like decreased heart rate/blood pressure, are possible, but unlikely. The medicine has to be given with food as it can cause the blood sugar to go low if not given with food. And propranolol can increase wheezing with respiratory infections so I recommend stopping the propranolol if an infant is sick with a virus and restarting it when the baby feels better. What is a port wine stain? A port wine stain is a collection of capillaries that discolor the skin so that it creates a patch that is pink or red. Port wine stains are present at birth and do not grow or change. How are port wine stains treated? Port wine stains are treated with lasers that target the hemoglobin in the capillaries and destroy it. Treatments are done every 6-8 weeks and the stain gradually lightens. Typically anywhere from 10-20 treatments are needed. Laser does not always guarantee that the stain will be completely removed, but it lightens them considerably. Laser treatments are painful and sometimes these treatments are done under general anesthesia or with topical numbing cream. If you have any other questions regarding vascular birthmarks and how it is affecting your child, please schedule an appointment with Dr Swanson, our pediatric dermatologist. What is a pediatric dermatologist? A pediatric dermatologist is someone that has undergone extensive training to deal with the specific skin conditions and issues that affect children. Pediatric dermatologists have typically completed medical school, a general dermatology residency, and a pediatric dermatology fellowship. While all dermatologists receive some experience dealing with children with skin problems, a pediatric dermatologist has chosen to subspecialize and receive more extensive education and training with the pediatric population.