Macular stains. Macular stains appear anywhere on the body as mild red marks, but they are not elevated. They are the most common type of vascular birthmark. They can come in two forms: “angel kisses,” which may appear on the forehead and eyelids and usually disappear after age two; or “stork bites,” which will appear on the back of the neck and can last into the adult years. Because these marks are often mild and always harmless, they do not need to be treated.
Hemangioma. Hemangiomas are growths that are made up of many tiny blood vessels bunched together. Some hemangiomas are more serious. They are more common in females and premature babies. This birthmark is usually just a small mark on the face, trunk, or extremities (arms and legs). However, in some children, hemangiomas can be large and grow rapidly through the first year of life.
There are 2 types of hemangiomas: strawberry (or superficial), which are slightly raised and can appear anywhere on the body; or cavernous (deep), which are deeper birthmarks marked by a bluish color. Fortunately, most hemangiomas will go away on their own: 50% get better by age 5, 70% by age 7, and 90% by age 9.
If the hemangioma is small and not causing any problems, it can be watched to see if it gets better. Reasons to treat a hemangioma include problems with functions (such as sight, eating, hearing, or defecation), ulceration, bleeding, or pain.
If necessary, hemangiomas can be treated in different ways, each of which carries its own risks. Corticosteroid medication can be injected or taken orally (by mouth). Risks of corticosteroid medication include high blood pressure, high blood sugar, poor growth, or cataracts. Certain hemangiomas can also be treated with lasers to stop them from growing, and heal them. Rare risks associated with laser treatment include ulceration and scarring. In addition, both topical and oral beta blocker medication has been used to treat hemangiomas, but these medications also carry their own risks that should be carefully discussed with your dermatologist. In rare cases, a hemangioma can be removed with surgery.
Port wine stains. A port wine stain appears as a flat pink, red, or purple mark on the face, trunk, arms, or legs, and lasts a lifetime. Port wine stains are caused by abnormal development of blood vessels (capillaries). Over time, the port wine stain may become raised and thickened. Port wine stains on eyelids are thought to pose an increased risk of glaucoma. Physicians have tried many ways to treat port wine stains, including radiation, tattooing, freezing, dermabrasion, or sclerotherapy. Laser therapy is currently the treatment of choice, as it is the only method that destroys capillaries in the skin without causing damage to the rest of the skin. Port wine stains may be seen in certain medical disorders, such as Sturge-Weber Syndrome, whose symptoms include port wine stains on the face, vision problems, convulsions, intellectual disabilities, and perhaps even paralysis; and Klippel-Trenaunay Syndrome, in which a limb has port wine stains, varicose veins, and/or too much bone and soft tissue growth. Both of these syndromes are very rare.