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Birthmarks - red

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

Alternative Names

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

Causes, incidence, and risk factors

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 vascular birthmark. Their cause is unknown. The color results from the development of blood vessels at the site.

Strawberry hemangiomas (strawberry mark, nevus vascularis, capillary hemangioma, hemangioma simplex) may develop several weeks after birth.

Cavernous hemangiomas (angioma cavernosum, cavernoma) are similar to strawberry hemangiomas but they are deeper.

Salmon patches (stork bites) are extremely common. They appear on 30-50% of newborns.

A port wine stain is a flat hemangioma made of expanded blood capillaries (tiny blood vessels). Port wine stains on the face may be associated with Sturge-Weber syndrome.

Symptoms

The main symptoms include:

The different types of birthmarks have their own appearance and typical location:

  • Cavernous hemangiomas may appear as a red-blue spongy mass of tissue filled with blood.
  • Port wine stains are most often located on the face. The size varies from very small to over half of the body surface.
  • Salmon patches are small, pink, flat spots. They are small blood vessels (capillaries) that are visible 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 the infant cries or during temperature changes.
  • Strawberry hemangiomas may appear anywhere on the body. They are most common on the neck and face. These areas consist of small blood vessels that are very close together.

Signs 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.

The nevus flammeus type of hemangiomas may not need treatment unless it:

  • Affects your appearance
  • Causes emotional distress
  • Is painful
  • Has changes 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 yellow pulsed-dye laser can be used.

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:

Expectations (prognosis)

Birthmarks rarely cause problems, other than changes in appearance. Many birthmarks go away on their own by the time a child is of school age, but some are permanent.

Strawberry hemangiomas usually grow quickly, stay the same size, and then go away. Most strawberry hemangiomas go away by the time the child is 9 years old. However, there may be some slight change in color or puckering of the skin where the birthmarks was. 

Some cavernous hemangiomas go away on their own, usually as a child approaches school age.

Port wine stains are often permanent.

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.

Complications

  • Emotional distress because of appearance
  • Discomfort or bleeding from vascular birthmarks (occasional)
  • Scarring or complications after surgical removal

Calling your health care provider

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: Mosby Elsevier; 2009:chap 23.

Updated: 11/20/2012

Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.


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