A vascular birthmark is a discoloration of the skin that is caused by blood vessels that don't form correctly. They are present at birth or appear shortly after birth. There are three major types of vascular birthmarks:

• Salmon patch (nevus simplex) is a flat patch of pink or red skin, often small, usually with poorly defined borders. Salmon patches are seen in 30% to 40% of newborns. They typically are found at the nape of the neck ("stork bite"), on the forehead between the eyebrows ("angel's kiss") or on the eyelids. Often, they are more noticeable during crying or changes in temperature.



• Strawberry hemangioma is a raised bright red spot, often small, usually soft and compressible, with well-defined borders. It occurs most commonly on the face, scalp, chest or back. It may be present at birth but more often appears during the first one or two months of life. Strawberry hemangiomas occur in 1% to 3% of infants. In rare cases, they interfere with vital organs or are associated with life-threatening complications.



• Port-wine stain (nevus flammeus) is a flat patch of purple or dark red skin, often large, usually with well-defined borders. It usually is on one side of the face or neck and is present at birth. (Mikhail Gorbachev, former president of the Soviet Union, has a port-wine stain on his forehead.) Port-wine stains affect less than 1% of infants. In rare cases, they are associated with other abnormalities.

Vascular birthmarks are painless and usually don't cause any symptoms other than the skin discoloration.

A strawberry hemangioma may cause other symptoms if its location interferes with a vital organ. For example, a lesion on the neck could press down on the trachea and interfere with breathing, and a hemangioma near the eye or on the ear could limit vision or affect hearing.

In rare cases, a port-wine stain is associated with other abnormalities. For example, some children who have a stain around the eyelids also have Sturge-Weber syndrome, a condition that is associated with glaucoma, seizures and other problems.

A doctor can diagnose these birthmarks by looking at them. When strawberry hemangiomas or port-wine stains are located in an area that could affect organs beneath them or near them, the doctor may order additional imaging studies such as a computed tomography (CT) scan or magnetic resonance imaging (MRI).

Salmon patches usually fade within the first year of life. Strawberry hemangiomas get larger for 6 to 12 months, sometimes rapidly. Then the growth stops and the hemangioma eventually shrinks and disappears. Ninety percent of strawberry hemangiomas disappear by the time children are 9 years old. Port-wine stains usually grow in proportion to the body and persist into adulthood. They may darken or thicken and develop tiny bumps.

There is no way to prevent vascular birthmarks.

No treatment is necessary for salmon patches, which usually fade within the first year of life. For most strawberry hemangiomas, the best cosmetic results are achieved when the birthmarks are allowed to go away naturally, without treatment. Some hemangiomas, for example those that interfere with a vital organ, are treated with laser therapy, oral or injected steroids, or surgical removal. Port-wine stains can be covered with opaque cosmetic creams such as Dermablend or Covermark. They also can be removed by laser therapy.

You should discuss treatment options with a dermatologist or plastic surgeon who has experience in treating vascular birthmarks.

Birthmarks should be evaluated by a doctor soon after they appear and at regular intervals after that, particularly to monitor the growth of strawberry hemangiomas.

Salmon patches fade and have no associated problems. The majority of strawberry hemangiomas eventually disappear with no associated problems, although approximately 10% of people affected are left with minor skin changes. Laser therapy can remove most port-wine stains with minimal scarring or discoloration. For hemangiomas involving vital organs and port-wine stains associated with other abnormalities, the outlook varies. For the best outcome, seek early evaluation and treatment by an experienced doctor.

Vascular Birthmarks Foundation
P.O. Box 106
Latham, NY 12110
Phone: (877) 823-5665
http://www.birthmark.org/

American Academy of Dermatology
P.O. Box 4014
Schaumburg, IL 60168-4014
Phone: (847) 330-0230
Toll-Free: (888) 462-3376
Fax: (847) 330-0050
http://www.aad.org/