Vascular birthmarks, hemangiomas, and vascular malformations are rare disorders when differences occur in the development of blood vessels anywhere in the body. This can happen to arteries, veins, capillaries and/or lymphatic vessels. Sometimes vascular birthmarks are associated with other underlying disease or systemic anomalies.
Vascular Birthmarks are divided into two categories:
Correctly diagnosing the birthmark will allow the appropriate treatment. The Craniofacial Team of Texas clinic is an interdisciplinary clinic that diagnoses and treats vascular birthmarks. Several different doctors from different specialties are present at appointments including: interventional radiology, dermatology, plastic surgery, genetics, orthopedics, and hematology/oncology.
What is a hemangioma?
A hemangioma is a type of birthmark comprised of blood vessels. Hemangiomas may be present at birth (faint red mark) though most appear days to weeks after birth. The majority of hemangiomas occur in the head or neck area but can occur anywhere. Hemangiomas occur three-five times more often in females than in males. They are also more common in low birth weight infants and with twins or triplets.
What is a vascular malformation?
A vascular malformation is present at birth. It can be made up of arteries, veins, capillaries, or lymphatic vessels or any combination of those vessels. A very common type of vascular malformation is capillary malformation or port wine stain.
What is the difference between a hemangioma and a vascular malformation?
Most hemangiomas are usually not present at birth or are very faint red marks. Shortly after birth, however, they grow rapidly – often faster than the child’s growth. Over time, they become smaller (involute) and lighter in color. The process of involution may take several years. There are rare cases of congenital hemangiomas.
Vascular malformations are present at birth and enlarge proportionately with the growth of the child. They do not involute spontaneously and may become more apparent as the child grows.
What causes hemangiomas and vascular malformations?
The cause for hemangiomas and vascular malformations is usually sporadic, occurring by chance. There are several different theories for hemangiomas and vascular malformations. The lesions appear to be due to differences in blood vessel development. Genes may play a role in the occurrence of these lesions. Both hemangiomas and vascular malformations may occur in association with other physical findings.
What should I do if my child has a hemangioma or vascular malformation?
It is best to seek the care of a specialist to help guide you and your child’s primary care physician in your child’s care.
Treatment for hemangiomas:
Treatment for hemangiomas depends upon their size, location, and severity. Even though hemangiomas may disappear over time, hemangiomas that cause bleeding problems, feeding or breathing difficulties, growth disturbances, impairment of vision, or may be in areas that are cosmetically sensitive, such as the face, may benefit from early treatment. Treatment may include the following:
- Medical therapy such as steroids or propanolol
- Laser surgical removal
- Embolization of the blood vessels (injection of material into the blood vessels to block the blood inflow)
Treatment for vascular malformations:
Treatment for vascular malformations depends upon the type of the malformation. Each type of malformation is treated differently. Laser therapy is usually effective for capillary malformations or port wine stains, though multiple treatments are required. Arterial malformations are often treated by embolization (blood flow into malformation is blocked by injecting material near the lesion). Venous malformations are usually treated by direct injection of a sclerosing (clotting) medication which causes clotting of the channels. Most often, a combination of these various treatments is used for effective management of the lesion. Surgery may also be indicated. Vascular malformations conditions treated:
- Infantile hemangiomas
- Rapidily Involuted Congenital Hemangioma (RICH)
- Non Involuted Congenital hemangioma (NICH)
- Tufted angioma
- Pyogenic granuloma
Slow Flow Vascular Malformations
- Capillary (CM) – port-wine stain
- Lymphatic malformation (LM)
- Venous (VM)
- Blue-rubber bleb nevus syndrome
Fast Flow Vascular Malformations
- Arteriovenous malformation (AVM)
- Arteriovenous fistula (AVF)
- Klippel-trenaunay syndrome
- Proteus syndrome
- Parkes-Weber syndrome
- Sturge-Weber syndrome
Glossary of common (or older) names of vascular birthmarks
- Angel kiss – refers to a birthmark that is a capillary malformation, usually found on the face
- Cystic hygroma – this is a term that is no longer used for a lymphatic malformation found on the neck or axilla
- Salmon patch or macular stain – capillary malformation found either on the face or lower back, sometimes butterfly shaped
- Strawberry hemangioma – infantile hemangioma
- Stork bite – capillary malformation usually found on the nape of the neck
Vascular Birthmarks Web Resources:
- National Organization of Vascular Anomalies www.novanews.org
- Vascular Birthmarks Foundation www.birthmark.org
- PHACE registry www.texaschildrens.org/carecenters/Dermatology/phace.aspx
- Proteus Syndrome Foundation http://www.proteus-syndrome.org/
- Sturge Weber Foundation http://www.sturge-weber.org/
If you would like more information about vascular birthmarks, please contact the Craniofacial Team of Texas by calling 512-377-1142 or toll free 877-612-7069 to schedule an appointment or complete an online appointment request.