What parents should know about birthmarks/Hemangioma

Many babies develop birthmarks in the first few weeks of life. Many of those birthmarks are harmless and will disappear with age. But some will need special treatment to prevent issues as the child grows.

Jade Elliott spoke with Dr. Kate Puttgen, Intermountain Healthcare, about birthmarks on this episode of the Baby Your Baby Podcast.

Some infants develop a hemangioma, a non-cancerous tumor made of excess blood vessels. Hemangiomas can be superficial with a red color, or deep beneath the skin with a bluish color, or a mix of superficial and deep with both red and blue coloring, said Dr. Kate Puttgen, a pediatric dermatologist with Intermountain Healthcare. They grow rapidly in the first three to five months of life.

“It’s critical for hemangiomas to be detected early,” Dr. Puttgen said. “Most babies do fine with diagnosis and watchful waiting, but it’s important to work with a pediatrician who can refer the child to a specialist when necessary to ensure the hemangioma is not more dangerous.”

Hemangiomas occur in up to 10 percent of Caucasian infants, and are more common in babies of low-birth weight and who are born prematurely. They also are up to three times more common in girls than in boys.

Hemangiomas can develop anywhere on the body, and go through a period of growth and stabilization, and then decrease in size. Many will eventually disappear, but some can leave behind significant scarring or cause functional problems, such as with vision or feeding, depending on their size and location, Dr. Puttgen said.

Most hemangiomas present by about 2 weeks of age, and will at least double in size in the first two months of life. Eighty percent of the time, the maximum size will be reached by the time the baby is 3 months old, and by age 5 months, the vast majority have essentially finished growing. Deep hemangiomas and larger hemangiomas usually have a longer growth phase.

But in rare cases, a hemangioma can grow for longer periods of time or, if on the head or neck, can create distortion to the face, and result in disfiguring scar tissue or eye damage if left untreated, Dr. Puttgen said.

“The bottom line is, the majority of birthmarks in babies will not adversely affect their growth and development,” she said. “For other more complicated hemangiomas, we have excellent treatments, and can prevent the need for surgery or laser treatment before the child starts school if we start medicine as soon as possible in most cases.”

Beta blockers, commonly used for decades in babies with heart issues, are an effective treatment for hemangiomas, without significant side effects for most babies. The beta blockers shrink hemangiomas, and come in oral or topical versions. They are most effective when used in the baby’s first four months of life, though children as old as 5 years have benefited.

“Well-child checkups are a great time to talk to pediatricians about skin concerns, and address issues early on,” Dr. Puttgen said. “If a parent notices a birthmark, they should feel empowered to speak up and consult with their provider to determine whether a specialist is needed, and know that there are safe and effective treatments.”

For more information about birthmarks, go to primarychildrens.org

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.