Birthmarks

Treatment Overview

Many birthmarks fade or disappear over time. Other birthmarks do not fade. Only rarely does a birthmark need treatment because it is causing a medical problem with sight, breathing, hearing, speech, or movement. Birthmarks that grow on internal organs need treatment.

There are several ways to fade, shrink, or remove some types of birthmarks. But treating can be a big decision, because treatments can be painful and don't always work.

Your baby's doctor might be able to tell you whether a birthmark will grow, shrink, or fade. This is also a good time to talk about any worries you have about a birthmark. You may find it helps to be reassured that a birthmark is normal and painless. Even a hemangioma that grows at first is likely to shrink during a child's first years of life.

If your child’s birthmark bothers you, try not to let your child know. Ask others not to make a big deal out of it. Focus instead on your child's many positive qualities and skills.

If a birthmark is upsetting your child, ask your child’s doctor to talk to your child about it. Getting reassurance from a doctor often helps a child. If not, a counselor or support group may be a good way to help your child feel better.

If you or your child wants to hide a birthmark, you can try makeup or different hairstyles.

Birthmark treatments

Treatment for birthmarks can be controversial. It is important to know the benefits and risks of treatment and to understand that not all birthmarks can be treated. Ask your doctor to show you photographs of birthmarks that have been treated and photographs of birthmarks that have not been treated.

Of all the types of birthmarks, hemangiomas are the most likely to be treated. Although hemangiomas can look painful or ugly, most shrink without treatment. The type of treatment given depends on the age of the child, as well as the type, size, rate of growth, and location of the hemangioma. For example, a fast-growing hemangioma near a child's eye needs treatment, as do those that may leave big scars or affect vision. Hemangiomas on internal organs may need treatment.

Treatment for birthmarks includes:

• Corticosteroids, such as prednisone. Corticosteroids can be taken as pills or injected directly into a hemangioma to shrink it or to stop it from growing. Side effects of corticosteroids (such as weight gain or round face) usually disappear after treatment stops. Most birthmarks treated with corticosteroids shrink within 2 to 4 weeks.
• Interferon alfa-12. In very rare cases, corticosteroids do not shrink or stop a hemangioma from growing. Interferon alfa-12 may then be used to reduce the size of the hemangioma. This treatment usually lasts 3 to 6 months and has serious side effects including fever, irritability, neutropenia, and liver problems.
• Laser therapy. Lasers are often used on birthmarks that are close to the surface of the skin, such as port-wine stains. Sometimes, laser therapy can stop a hemangioma from growing, but it may not work to treat a deeper hemangioma.
• Surgery. Surgery is used for a hemangioma that is causing a medical problem, after other treatments have not worked. When a hemangioma is on an internal organ, it may need to be removed. Surgical removal of a hemangioma may leave a scar, which may be removed or faded with other treatments.

After your child's birthmark has been treated with surgery or laser therapy, keep your child's fingernails trimmed short to keep him or her from scratching the treated area. It also is important to keep your child out of the sun for several weeks after surgery. Until your child's treated areas are completely healed, use sunscreen on the treated areas when your child is out in the sun.

Birthmarks are best treated by plastic surgeons or dermatologists.

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Author:	Kathe Gallagher, MSW	Last Updated: April 18, 2007
Medical Review:	Michael J. Sexton, MD - Pediatrics Randall D. Burr, MD - Dermatology
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