About Hemangiomas and Vascular Birthmarks

Vascular birthmarks are the most common benign tumors of infancy, affecting approximately 400,000 babies each year. These are benign growths that range in appearance from flat, faintly red skin lesions to bulky deep lesions that can become large enough to interfere with vision, breathing, and swallowing.

Vascular birthmarks are generally classified as either hemangiomas or vascular malformations. Hemangiomas are not usually visible at birth, but are recognized within days or weeks of delivery. They often appear in the head and neck area, but may occur anywhere on the skin or even internally. Hemangiomas initially appear as a flat, discolored area that may be mistaken for a bruise or rash. They usually undergo two periods of rapid growth, the first at 2 to 8 weeks of age and the second between 4 and 6 months of age.

Hemangiomas, begin to regress, or involute, shortly after the first year of life. Some hemangiomas inviolate rapidly and leave behind skin changes that are barely noticeable. Others may take years to regress completely and still leave behind considerable deformities that require surgical correction. The Center's physicians use the latest advances in medical, laser, and surgical therapies to customize a treatment plan for each child.

Vascular malformations, unlike hemangiomas, are usually present at birth and do not undergo a rapid growth phase. They do not involute, and will typically grow with the patient, often requiring surgical excision.

Several different types of vascular malformations are recognized:

Venous malformations - usually deep blue or purple in color; will increase in size if affected area is held in dependent position or tourniquet applied

Lymphatic malformations (also known as lymphangiomas, or cystic hygromas) - no skin discoloration; rubbery to touch

Venular malformations (also known as port wine stains) - cause discoloration of skin from. light pink to dark red, with cobblestoning in severe cases. May be associated with neurologic or bony abnormalities. Arteriovenous malformations - variable in color; complex mass of arteries and veins associated with high blood flow; pulse may be heard through lesion.

The Center's physicians simplify the surgical excision of vascular malformations through the use of sclerosis and embolization, injection techniques performed under radiologic guidance to reduce flow through the mass. Specialists in plastic and head and neck surgery often team up to complete the removal of these difficult lesions.

Center for Hemangiomas and Vascular Birthmarks

The Center is the first interdisciplinary program in the Mid-Atlantic region for treatment of hemangiomas and vascular birthmarks in children and adults. Its staff comprises five core specialists in plastic surgery, head and neck surgery, dermatology, and radiology and additional consultants in orthopedic surgery, general surgery, neurosurgery, gastroenterology, pulmonary medicine, dentistry, genetics, and psychology.

It has been estimated that up to 60 percent of vascular birthmarks are misdiagnosed, and many are therefore treated inadequately or inappropriately. The multidisciplinary approach to these complex disorders combines several expert opinions into a comprehensive treatment plan that may involve one or more of the Center's specialists and regular follow-up with the entire staff. The Center's physicians offer the latest advances in diagnostic, medical, laser, and surgical technology including:

  • Magnetic resonance imaging (MRI), including non-invasive angiography and venography
  • Angiography and embolization
  • Local and systemic steroid therapy
  • Interferon therapy
  • Surface and intralesional laser therapy, using pulsed dye, KIT, Nd:YAG, and carbon dioxide lasers
  • Picibinal (OK-432) sclerotherapy
  • Multidisciplinary surgical resection