Dear Parent of a Baby with a Hemangioma

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Dear Concerned Parent,

If you’re like many parents who have noticed a prominent, raised mark on your baby’s skin, I completely understand your worry. It’s natural to feel alarmed and to seek immediate answers.

As a father myself, I can relate to those feelings of anxiety (don’t let my wife know!). However, as a pediatric plastic surgeon, I want to reassure you that what you’re seeing is likely a hemangioma. While the term may sound daunting, rest assured that these marks are usually benign and not as concerning as they may appear.

Hemangiomas are striking, reddish birthmarks that typically emerge within the first few weeks of life, with a possibility of growing for about 10 to 14 months. Essentially, they are harmless growths made up of a cluster of blood vessels in the skin and fat layers. You may have heard them referred to as “strawberry marks” or “vascular birthmarks.” Though they don’t appear at birth, their gradual development can understandably cause anxiety for new parents. If I encountered one on my daughters without prior knowledge, I’d share your concerns.

The good news is that hemangiomas are generally harmless and, in most cases, will shrink and fade as your child grows, often by the age of five. I see these frequently in my practice.

What Causes Hemangiomas?

Despite extensive research, the exact origin of hemangiomas remains unclear. However, there are some reassuring facts that might alleviate your fears:

  1. They are not inherited,
  2. They do not result from exposure to harmful substances during pregnancy, and
  3. They do not become cancerous, spread, or indicate serious underlying health issues in most instances.

Pretty reassuring, right?

What Should You Do Next?

It’s important to obtain a correct diagnosis. While the majority of hemangiomas can be identified visually by a board-certified pediatric plastic surgeon, other similar marks, like a “Cupid’s kiss” or a “stork bite,” may be mistaken for hemangiomas. These types are also harmless but differ significantly in appearance and do not follow the same lifecycle as hemangiomas. Thus, it’s crucial to consult a specialist to ensure accurate identification.

Once you have a diagnosis, you can discuss a plan of action. What if the hemangioma grows too large? What if it bleeds, swells, or peels? Don’t panic; these are all hypothetical scenarios. Most hemangiomas can simply be monitored until they resolve on their own, even larger ones located on the chest, abdomen, scalp, arms, or legs. However, if it happens to be on your child’s face and is affecting her vision, surgical removal is an option worth considering. I believe removal is only necessary when it impacts key functions or causes significant disfigurement. Additionally, you could discuss the use of propranolol, a medication initially intended for blood pressure control, which has shown promise in managing hemangioma growth during the first year of life. But if the hemangioma isn’t affecting your child’s quality of life, my usual recommendation is to leave it be.

As a surgeon and a dad, I want you to know that you’re not alone in this. These birthmarks are quite common, affecting one in ten children. Don’t hesitate to consult a specialist to ease your worries. In the meantime, take a deep breath. Your baby is going to be just fine, and so will you.

Additional Resources

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Summary

Hemangiomas are common, benign birthmarks that typically appear in infants and usually resolve on their own. While their appearance can be alarming, they do not pose significant health risks. Seek a proper diagnosis and consider a plan with your pediatric specialist regarding the management of the hemangioma. Remember, you are not alone and most cases are harmless.


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