Understanding Vascular Birthmarks On Your Baby, Including Treatment Options And Prognosis
Mark Quesenberry’s first child, Raven, was born with prominent birthmarks on her head and back. At Raven’s three-day-old check-up, her doctor diagnosed hemangiomas – excess vascular tissue that her body would eventually absorb.
Over the next several weeks, the flat hemangiomas started to bubble like balloons. The doctor assured the first-time parents that they would “likely reabsorb by age 2.”
While waiting for the hemangiomas to be reabsorbed, the Quesenberrys bought their daughter a closetful of hats and even named the birthmarks. “We named the one on her head ‘the bonk,’ says Quesenberry, “and the one on her back the ‘reset button.’”
It took years – not weeks or months – for the hemangiomas to go away. Raven was 10 years old.
Dr. Linda Rozell-Shannon, PhD understands the Quesenberry’s story. Her own daughter had a hemangioma, and Linda co-authored the first book for parents on the subject: Birthmarks: A Guide to Hemangiomas and Vascular Malformations. Here, Linda answers questions about this largely unreported medical phenomenon.
What are vascular birthmarks?
The most common vascular birthmark is the hemangioma, a flat pink lesion usually located on the head or neck. Unlike port wine stains, which are present at birth, hemangiomas appear days or weeks after birth. A hemangioma grows for up to one year and – as in Quesenberry’s case – can take up to 10 years to shrink.
Pictured, right, is a baby with a vascular birthmark on her head. The picture, below, is the same baby after the birthmark has gone away.
When should a parent seek treatment?
As a general rule-of-thumb, if the birthmark has gotten larger or darker or has not subsided since birth, parents should see a vascular birthmarks specialist. 90% of hemangiomas resolve on their own and require no treatment, but 10% become problematic, disfiguring and even life threatening. Parents should immediately consult a specialist if the birthmark begins to bleed or ulcerate.
What are the risks if not treated?
The primary concern with a hemangioma is disfigurement that is more than cosmetic. Some hemangiomas obstruct a vital structure such as the eyes, mouth, nose, or ears, leading to vision loss, feeding problems or hearing problems.
Additionally, there is risk to the child’s self esteem. Young children with facial deformities suffer psychosocial trauma from the reactions of people who stare, tease or unwittingly withdraw in fright. The longer the wait, the more damage there is to the child’s self-esteem.
What treatments are available?
Different treatments have different expectations and outcomes:
- The leading first line of treatment is the pulse dye laser, which lightens the color of the lesion and stops it from growing.
- Depending on the size, location, and rate of growth of the birthmark, topical steroid creams can produce good results.
- If laser and drug therapies – which work over time – fail, the lesion can be corrected with surgery, which provides immediate results.
What are the biggest challenges faced by parents?
A correct diagnosis is crucial, so finding the right physician is the first hurdle.
The next step is getting insurance approval for treatment. Unfortunately, insurance companies consider the treatment of a hemangioma to be a cosmetic issue rather than a medical necessity. Hemangioma surgeons have noted that nearly 90% of their cases are denied treatment. Without affordable treatment, children are left with a severe deformity, breathing difficulties, eating issues, blindness and, in some cases, death.
The Vascular Birthmarks Foundation (VBF) [founded by Dr. Rozell-Shannon] networks families into proper treatment and works side by side with them to appeal insurance companies rejections.
For now, parents have to fight for the right physician, the right diagnosis and the right treatment. Vascular birthmarks are the most common lesion of infancy, yet they are the least understood and the most neglected.
Every concerned parent should seek the opinion of a vascular birthmark specialist, simply to allay fears. A parent full of worry has a difficult time enjoying the wonderful milestones a new baby achieves.
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