Parenting
Dear Concerned Caregiver,
If you’re among the many parents puzzled by that prominent, raised “birthmark” on your baby’s skin, I completely understand the worry that prompts you to reach out repeatedly or rush into a clinic. The fear you feel is valid.
As a fellow parent, I can relate to that sense of anxiety (don’t let my partner know). As a pediatric plastic surgeon, let me reassure you: what you are witnessing is a hemangioma. While the term might sound daunting, or the mark itself may look alarming, rest assured they are not as frightening as they seem.
Hemangiomas are large, reddish birthmarks that often appear within the first few weeks of life and can grow for up to 10 to 14 months. Essentially, they are benign tumors made up of clusters of blood vessels nestled in the skin and fatty layers. Known by names like “strawberry mark” or “vascular birthmark,” they typically don’t manifest at birth (as you may have observed), leading to understandable concern for new parents. If I encountered one for the first time on one of my children (without prior knowledge), I would share your concern.
But there’s no need for panic—hemangiomas are universally benign and usually diminish and fade by the time children reach five years of age. I see them regularly in my practice.
So, why do they occur? Despite extensive research, the exact cause of these peculiar birthmarks remains unclear. Several scientific theories exist (which I won’t delve into here), but to ease your mind, here are some key points:
- They are NOT hereditary,
- They are NOT caused by exposure to harmful substances during pregnancy,
- They do NOT become cancerous, nor do they spread like cancer, and they typically don’t indicate serious underlying health issues.
Good news, right?
Now, what’s next? First, ensure you get an accurate diagnosis. While over 90% of hemangioma cases can be identified by their appearance (preferably by a board-certified pediatric plastic surgeon), other types of birthmarks can resemble a hemangioma—like a “Cupid’s kiss” (a red mark on the forehead) or a “stork bite” (found on the nape of the neck, which my kids had at birth). These are harmless but differ significantly in appearance and lifecycle, making it crucial to consult with a specialist right away for clarity.
Once you have a proper diagnosis (which you likely do), the next step is to create a plan of action. What if it becomes too large? What if it bleeds? What if the skin swells or flakes? Try not to panic—these are all hypothetical scenarios. Most hemangiomas can be monitored until they naturally resolve over the years, even those on the chest, belly, or limbs. If the hemangioma is on your child’s face and pressing on her eye, surgical removal is an option, but it has its pros and cons. Generally, I believe removal is necessary only if it obstructs vision or causes significant disfigurement. You may also discuss with your specialist the use of propranolol, a medication originally for high blood pressure, which has shown effectiveness in managing hemangioma growth in infants. However, if it’s not affecting your child’s quality of life, I often advise taking a wait-and-see approach—that’s just my perspective.
My primary message to you, as a surgeon and parent of two little ones: know you’re not isolated in this experience, and understand that these birthmarks are harmless. About one in ten children will have a hemangioma—it’s quite common. Don’t hesitate to consult with a specialist to address your concerns, but in the meantime, take a deep breath. Your baby will be alright. You will be alright. I assure you.
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In summary, hemangiomas, while initially concerning, are typically benign and self-limiting. Understanding what they are and consulting with the right specialists can ease much of the apprehension parents feel.
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