Birthmarks - red

  • Definition
    • Red birthmarks are skin markings created by blood vessels close to the skin surface. They develop before or shortly after birth.

  • Alternative Names
    • Strawberry mark; Vascular skin changes; Angioma cavernosum; Capillary hemangioma; Hemangioma simplex

  • Causes
    • There are two main categories of birthmarks:

      • Red birthmarks are made up of blood vessels close to the skin surface. These are called vascular birthmarks.
      • Pigmented birthmarks are areas in which the color of the birthmark is different from the color of the rest of the skin.

      Hemangiomas are a common type of vascular birthmark. Their cause is unknown. Their color is caused by the growth of blood vessels at the site. Different types of hemangiomas include:

      • Strawberry hemangiomas (strawberry mark, nevus vascularis, capillary hemangioma, hemangioma simplex) may develop several weeks after birth. They may appear anywhere on the body, but are most often found on the neck and face. These areas consist of small blood vessels that are very close together.
      • Cavernous hemangiomas (angioma cavernosum, cavernoma) are similar to strawberry hemangiomas but they are deeper and may appear as a red-blue spongy area of tissue filled with blood.
      • Salmon patches (stork bites) are very common. Up to half of all newborns have them. They are small, pink, flat spots made up of small blood vessels that can be seen through the skin. They are most common on the forehead, eyelids, upper lip, between the eyebrows, and on the back of the neck. Salmon patches may be more noticeable when an infant cries or during temperature changes.
      • Port wine stains are flat hemangiomas made of expanded tiny blood vessels (capillaries). Port wine stains on the face may be associated with Sturge-Weber syndrome. They are most often located on the face. Their size varies from very small to over half of the body's surface.
  • Symptoms
    • The main symptoms of birthmarks include:

  • Exams and Tests
    • A health care provider should examine all birthmarks. Diagnosis is based on how the birthmark looks.

      Tests to confirm deeper birthmarks include:

  • Treatment
    • Many strawberry hemangiomas, cavernous hemangiomas, and salmon patches are temporary and do not need treatment.

      Port wine stains may not need treatment unless they:

      • Affect your appearance
      • Cause emotional distress
      • Are painful
      • Change in size, shape, or color

      Most permanent birthmarks are not treated before a child reaches school age or the birthmark is causing symptoms. Port wine stains on the face are an exception. They should be treated at a young age to prevent emotional and social problems. A laser can be used to treat them.

      Concealing cosmetics (such as Covermark) may hide permanent birthmarks.

      Oral or injected cortisone may reduce the size of a hemangioma that is growing quickly and affecting vision or vital organs.

      Other treatments for red birthmarks include:

  • Outlook (Prognosis)
    • Birthmarks rarely cause problems, other than changes in appearance. Many birthmarks go away on their own by the time a child reaches school age, but some are permanent. The following development patterns are typical for the different types of birthmarks:

      • Strawberry hemangiomas usually grow quickly and stay the same size. Then they go away. Most strawberry hemangiomas are gone by the time a child is 9 years old. However, there may be a slight change in color or puckering of the skin where the birthmark was.
      • Some cavernous hemangiomas go away on their own, usually as a child gets close to school age.
      • Salmon patches often fade as the infant grows. Patches on the back of the neck may not fade. They usually are not visible as hair grows.
      • Port wine stains are often permanent.
  • Possible Complications
    • The following complications can occur from birthmarks:

      • Emotional distress because of appearance
      • Discomfort or bleeding from vascular birthmarks (occasional)
      • Interference with vision or bodily functions
      • Scarring or complications after surgery to remove them
  • When to Contact a Medical Professional
    • Have your health care provider look at all birthmarks.

  • Prevention
    • There is no known way to prevent birthmarks.

  • References
    • Habif TP. Vascular tumors and malformations. In: Habif TP, ed. Clinical Dermatology. 5th ed. St. Louis, MO: Elsevier Mosby; 2009:chap 23.

      James WD, Berger TG, Elston DM. Dermal and subcutaneous tumors. In: James WD, Berger TG, Elston DM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 11th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 28.

      Morelli JG. Vascular disorders. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 642.

      Rapini RP. Vascular proliferations and neoplasms. In: Rapini RP, ed. Practical Dermatopathology. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 25.