Treatment for birthmarks
February 5, 2010 by Medical Dude
Filed under Birthmarks
A birthmark is diagnosed based on appearance and therefore diagnostic tests are not usually needed. While the vast majority of hemangiomas will start to shrink on their own after one year, some may leave the skin deformed or stretched. In these cases, plastic surgery may be an option to improve the appearance of the distorted skin. If the hemangioma is complicated or large, medication may be required (usually the beta-blocker propranolol). If the hemangioma has formed an ulcer, surgery or laser treatment may be required.
Some birthmarks may cause complications that will need treatment. A hemangioma near a child’s eye, nose or mouth may cause problems with vision, feeding and breathing respectively. Hemangiomas on the lip or around the nappy area are more likely to ulcerate, which can bleed and be painful.
The exact method of treatment will depend on the severity and location of the hemangioma.
For example, if the hemangioma is affecting a child’s vision, they will usually need to take propranolol, taken as a liquid. This will shrink the birthmark.
If a child has breathing difficulties because of a hemangioma in the airway, laser treatment of their airway during a micro-laryngoscopy and bronchoscopy may be needed. This test allows the doctor to look into the child’s airway using a small telescope called an endoscope. Propranolol may also be given. The child may need to have a tracheostomy which is an artificial opening into the windpipe to improve breathing.
Corticosteroid medications: Corticosteroids can be injected, given by mouth or applied to the skin. These medications are most effective when they are given during the growth phase. Sometimes long-term or repeated treatment is needed.
The risks are potentially serious, including poor growth, high blood sugar, high blood pressure and clouding of the normally clear lens of the eye (cataract).
Monitoring internal hemangiomas
If a hemangioma is present in a child’s internal organs, an ultrasound scan or magnetic resonance imaging (MRI) scan may be needed. An MRI scan uses a strong magnetic field and radio waves to produce detailed pictures of the inside of the body.
Port wine stains The treatment options are..
- ..pulsed dye laser treatment, which can fade the mark
..camouflage make-up, which can disguise it
Infants with port wine stains should be offered pulsed dye laser treatment early on, because at this stage the vessels are thinner and respond better to the treatment.
Pulsed dye laser treatment
Pulsed dye laser treatment lightens the affected area of skin and is the best available treatment for a port wine stain. A device that looks like a pen is held gently against the surface of the skin and a button is pressed, sending a shot of light to the skin. The light goes superficially into the skin and is absorbed by the blood vessel just beneath the surface, causing it to heat up. The heat damages the blood vessel and causes a bruise, which fades over the next one to two weeks. A local anesthetic numbs the area. A general anesthetic is used in younger children.
There are minimal side effects with laser treatment. Up to 10 treatment sessions may be needed at intervals of about three to four months. The treatment’s effectiveness will depend on how prominent and dark the affected area is.
Port wine stains tend to come back after completion of laser therapy (after two to four years), so further treatment will be needed.
Camouflage make-up
A special type of camouflage make-up can be prescribed. It will cover up the birthmark.
Salmon patches (stork marks) are blemishes that often disappear a few months after birth. They do not need treatment.
Treatment of hemangiomas is somewhat controversial. Some parents feel that hemangioma treatment is necessary because the marks can be disfiguring and may cause social or psychological problems. However, doctors may be hesitant to treat a hemangioma that is not causing physical problems. Hemangiomas usually fade gradually without treatment, and treatments have potential side effects.
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