Otolaryngology–Head and Neck Surgery
Birthmarks and Other Skin Anomalies
Overview
Birthmarks and other types of skin anomalies occur when blood vessels develop abnormally. They are relatively common, occurring in approximately 10 percent of all babies. Most are harmless, but some are serious and require treatment.
- Hemangiomas: These are vascular birthmarks, which often become visible a few days to a few weeks after birth. They often appear as “blemishes” over any part of the head, neck, body, and limbs, becoming more visible and raised over time. These can grow in size over several months, often stopping around one year of age.
- Port Wine Stains (PWS): These are pink or dark red flat vascular birthmarks, which are present at birth and are commonly found on the head and neck. They will be present for the lifetime of the individual and will not go away unless treated. The abnormally enlarged blood vessels, which are present in the PWS, will continue to increase in size throughout a patient's life.
- Nevus of Oto and Ito: These are blue-gray patches on the face and shoulder consisting of pigment in the dermis. These pigments have remained in the dermis instead of the epidermis where they are normally found. These lesions can either be congenital or acquired.
- Café au Lait (CAL): These spots are hyper-pigmented lesions of varying sizes, which may be light to dark brown. The presence of these lesions may be associated with congenital conditions such as neurofibromatosis. Typically, CAL spots are present at birth, although they may be difficult to notice. By the time a child is two or three years old, CAL spots are clearly visible. The size and number of CAL spots increase with age.
3Common Symptoms
- Noticeable marks on the skin, usually red or brown in color
- Blemishes that grow over time
- Blue-gray patches on the face and shoulder
Diagnosis and Treatment
Birthmarks and skin anomalies have specific treatment options based on each type.
The classic treatment for hemangiomas is observation because the majority of these birthmarks spontaneously regress. However, some hemangiomas, during the proliferative growth phase, can obstruct organs such as the eye, which impairs vision. Lesions such as these require treatment, which includes oral or injectable corticosteroid and laser treatments.
Lasers can be used to remove these abnormal blood vessels with minimal injury to adjacent structures such as collagen. Individuals of any age can be treated. Treatment should begin as early as possible, especially in children.
Lasers have been effective in removing the misplaced pigment cells in the dermis, thus lightening the blue-gray patches.
Because CAL spots are the result of an increase in pigment in the giant pigment cells, the pigment within the cells can be destroyed with lasers.
Visit Our Laser Center
The Carolyn and Peter Lynch Center for Laser and Reconstructive Surgery is an interdisciplinary center dedicated to the treatment of patients who require dermatological care and/or facial plastic reconstructive surgery.