Center for Hemangiomas and Vascular Birthmarks

Hemangiomas and Vascular Birthmarks

About Hemangiomas and Vascular Birthmarks

Vascular birthmarks are clusters of veins, arteries, or lymph channels that are found within or under the skin. They range from flat, faintly red skin lesions to bulky deep lesions that can become large enough to interfere with vision, breathing, or swallowing. Vascular birthmarks occur in about 400,000 babies each year and are generally classified as either hemangiomas or vascular malformations.

Hemangiomas, sometimes called "strawberry birthmarks," are often not visible at birth, but become visible on the skin within days or weeks of delivery.  They usually start as flat, discolored areas that may be mistaken for bruises or rashes, but grow rapidly during the first 4-6 months of life.  During this time, some hemangiomas may become bulky, often causing significant changes in a child's appearance or function.  Others may cause painful skin ulcers or bleeding.  Growth can continue up to about 12 months of age. 

Hemangiomas begin to shrink (involute) sometime after age 1.  Some shrink rapidly leaving skin changes that are barely noticeable. Others, even with years of involution, still leave behind considerable deformities that require surgical correction.  Early evaluation of hemangiomas allows us to identify and treat those most likely to cause functional or cosmetic issues, often preventing problems before they occur.

Vascular malformations, unlike hemangiomas, are usually present at birth.  They do not undergo a period of rapid growth, but grow slowly as the child ages. They also do not shrink, and therefore often require treatment.

There are several different types of vascular malformations:

  • Venous malformations are usually deep blue or purple and collapse with pressure
  • Lymphatic malformations cause a faint blue skin discoloration or blisters and are rubbery to touch
  • Venular or capillary malformations (port wine stains) cause light to pink to dark red discoloration of the skin and may be associated with neurologic or bony abnormalities
  • Arteriovenous malformations are complex masses of arteries and veins associated with rapid blood flow and a high risk of recurrence

Treatment Options

By using the latest advances in medical, laser and surgical therapies, the physicians of the Hemangiomas and Vascular Birthmarks Program ensure the best possible result without risking or damaging healthy skin or structures surrounding the birthmark or lesion. Common treatments for hemangiomas include oral and intralesional medications, laser treatment, and surgical removal.  Vascular malformations are treated with some combination of laser therapy, intralesional occlusion under radiologic guidance, and surgical removal.

Team Approach Means Better Treatment

Patients treated in Hemangiomas and Vascular Birthmarks Program are evaluated by doctors from several specialties, each of whom provides a special skill or expertise in managing vascular birthmarks.  Our physicians collaborate to design a treatment plan customized for each patient. Often treatment will involve the participation of several members of the physician team.

Program Staff

The program’s staff includes the core specialties of plastic surgery, head and neck surgery, dermatology and radiology, with additional consultants in orthopedic surgery, general surgery, neurosurgery, gastroenterology, pulmonary medicine, dentistry, genetics and psychology.

Co-Directors:

David H. Darrow, MD, DDS

ENT/Head & Neck Surgery

Dr. Darrow performs laser, medical, and surgical management of hemangiomas and vascular malformations of the head and neck. He completed a fellowship in pediatric ENT at Children’s Memorial Hospital, Chicago, and training in management of vascular lesions with Dr. Milton Waner of the Vascular Birthmarks Institute of New York.

Judith V. Williams, MD

Pediatric Dermatology

Dr. Williams has completed residency training in both dermatology and pediatrics. She served a fellowship in pediatric dermatology at the Children’s Hospital of San Diego where she attended the Vascular Anomalies Clinic. She specializes in laser and medical treatment of vascular lesions of the skin.

George R. Hoerr, MD

Pediatric Plastic Surgery

Dr. Hoerr completed residencies in general and plastic surgery at EVMS and the University of California at Irvine and a fellowship in pediatric plastic surgery at USC/Children’s Hospital of Los Angeles.  He performs laser, medical, and surgical management of hemangiomas and vascular malformations.

Other specialists:

John C. Agola, MD

Interventional Radiology

Dr. Agola is a fellowship-trained interventional radiologist from New York University with expertise in injection of vascular malformations.

Daniel W. Karakla, MD, FACS

Head & Neck Surgery

Dr. Karakla is highly skilled in surgery of complex vascular lesions involving the head and neck. He completed his fellowship training in head and neck oncologic surgery at Methodist Hospital of Indiana.

Eric J. Dobratz, MD

Plastic Surgery of the Face, Head, & Neck

Dr. Dobratz trained in Head and Neck Surgery at the University of Virginia and served a fellowship in plastic surgery of the head and neck at the University of Minnesota.  He has a special interest in nasal tip and other facial hemangiomas.

Frazier W. Frantz, MD

Pediatric Surgery

Dr. Frantz is a graduate of the surgery program at the Medical College of Virginia and completed a fellowship in pediatric surgery at Cincinnati Children's Hospital.  He has an interest in vascular lesions involving the trunk, extremities, and internal organs.

Appointments

We evaluate and treat children and adults with vascular birthmarks or hemangiomas of any kind in any location.  Call (757) 668-9850 or contact us by fax at (757) 668-9848 to schedule an appointment.

Locations

Children's Hospital of The King's Daughters in Norfolk:

The second and third Friday afternoons of each month in the ENT Clinic on the second floor, CHKD, 601 Children’s Lane, Norfolk, VA 23507


Children's Hospital of The King's Daughters Health and Surgery Center at Oyster Point:

The first Tuesday afternoon of each month on the second floor, 11783 Rock Landing Drive,

Newport News, VA 23606