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Birthmarks and Hemangioma

What are birthmarks?

Birthmarks are markings on your baby's skin that may endure for the whole life or may fade away with time. Some birthmarks are called "stork bites" (when they're on the back of the head) or "angel kisses" (when they're on the forehead or eyelids). These are red, mottled spots that generally disappear in several months from birth but sometimes may endure for years. Other kinds of birthmarks are more permanent.

Birthmarks are fairly small moles. However, some birthmarks are very large and brown and more ugly. They are often hairy. The only way to deal with this colour change is by surgical removal but this may be very difficult if the birthmark is large, spreads over creases of the body or is of a bizarre shape.

Birthmarks are of generally several types. They are discussed below:

Moles (Pigmented Nevi)

Moles are actually an abnormal multiplication of the pigment cells of the skin. Majority of the moles are very common entirely harmless lumps in the skin. They are usually brown or black, but may sometimes be pink. They can be smooth or irregular, flat or raised and may even be hairy. They can be present absolutely anywhere on the body.

Moles are not visible at birth and begin to appear in childhood and early adult life and continue to increase during adolescence, varying in size and colour from dark brown patches to fleshy bumps. An average adult has between 15-20 moles spread over the body.

In the early stages, moles may be inflamed and red, but they eventually settle down and become less obvious. Rarely, however they become cancerous. For this reason, any mole which appears later in life at the age of 35 should be got checked by a doctor. They may become darker and more noticeable during pregnancy, and with the use of contraceptive pills. It is advisable to get a mole removed if:

a) There is an increase in the blackness of the scar.

b) The colour is uneven.

c) The size of the mole changes very rapidly.

d) There are changes in the edge of the mole - an uneven or red edge.

e) There are tiny black dots around the mole.

f) If a mole has a tendency to bleed needs to be shown to the doctor.

g) There are itchy moles.

Ordinarily, moles are best left alone unless one is causing problems or is really unsightly. Removal, unless it is done carefully and by an expert, can leave behind ugly scars.


One of the most common types of birthmarks is called a hemangioma. These birthmarks happen when many new blood vessels group together in one place on the skin. Blood vessels are tiny tubes that carry blood through the body.

Types of Hemangioma's:

Port Wine Stains (Nevus Flammeus) - One kind of hemangioma is port wine stains. A port wine stain, or nevus flammeus, is a birthmark consisting of malformed, dilated blood vessels in the skin. These are flat red marks usually found on the face and scalp. They cannot be removed by cutting them out. These should be treated by laser as infrared treatment. They can be camouflaged.

Strawberry Hemangioma - An another kind of hemangioma is Strawberry Hemangioma and is developed soon after a baby is born and grows very rapidly from a bluish small mark to a bluish-red fleshy lump of blood vessels which can bleed. The mark increases in size very fast but eventually shrinks. By the age of ten, only a white scar remains. Avoid surgical treatment as it will cause a worse scar in the end.

Cavernous Hemangioma - Cavernous hemangioma is an another type of hemangioma. Large cavernous hemangiomas may develop secondary infections and ulcerate. Bleeding is common and may be significant following injury to the hemangioma.

Capillary Hemangioma - The capillary haemangioma or superficial angiomatous naevus is most commonly known as a strawberry haemangioma (strawberry birthmark, capillary naevus, haemangioma simplex). It is more common in premature babies and may appear when the baby is a few days or weeks old and rapidly grows over a few months.

Stork's Bill Mark

Some babies have a red birthmark on the nape of the neck which is usually covered by hair.

Dark Patches

Very large areas of brown hairy thickening may develop on the arms and trunk in the teens. It is not possible to remove them, as large scars are left and these reappear after a short time.

Mangolisan Spots

These occur in babies. They may have bluish birthmarks over the lower back. They are harmless and fade after 18 to 24 months.

Skin Tags

Small tags of skin are very common on the neck and in the armpits and groin. They can be removed by tying fine thread around the stalk. They can also be snipped off with scissors or burnt.

Can my child's birthmark be removed?

It depends on the condition of your child's birthmarks. Some of the conditions mentioned above (like a hemangioma) might require removal. If a birthmark is not causing any physical problems, then it is best to leave it alone and it will get removed on its own with time. Of course, a large hemangioma on your child's face can upset your mind but you should understand it as it will get lost on its own by the time your child's ready for school, and no doctor too would recommend you any special treatment in that case. Some experts have challenged this wait-and-see approach, though, arguing that enough of them never disappear completely, and that early intervention to treat certain birthmarks can be helpful. So you may want to get more than one opinion about treatment.

Treatment options for removal of Birthmarks

Treatment options may include cryosurgery - freezing off the birthmark - surgery, X-ray or laser therapy, or the application of steroids. There may be some scarring, which can sometimes be further improved by plastic surgery. Port-wine stains are difficult to remove completely but can usually be made lighter with laser therapy. Moles can usually be surgically removed.

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