What is a birthmark?
Any mark, spot, or bump that is present in or around the time of birth on the skin of an infant is a birthmark. Mothers are fond of giving these rather romantic names such as angel’s kisses, stork bites, or beauty marks. Most of these lesions are not particularly esthetically desirable.
What are the different types of birthmarks?
Birthmarks can be categorized according to their composition. Marks as a result of excessive accumulations of melanin are called pigmented birthmarks, since the great majority of them are brown to black. Other birthmarks appear lighter than the rest of the skin due to a relative lack of melanin.
Some birthmarks are composed of blood vessels and are called vascular birthmarks. They are generally red, blue, or purple. Other birthmarks are composed of lymphatic tissue (cystic hygroma), breast tissue, and epidermal tissue, which are often yellow to flesh-colored.
What are the characteristics of pigmented birthmarks?
Pigmented birthmarks can be flat or elevated. They may simply be due to excessive deposition of melanin pigment in the deeper layers of the skin called dermal melanosis. This is particularly common in more heavily pigmented infants and is commonly called a Mongolian spot. More frequently, there are accumulations of melanin produced by and contained in pigment cells called melanocytes. The medical term for such a concentration of melanin-producing cells is a nevus. These nevi are generally small, no larger than ¼ inch diameter, however, they can be quite large, covering a significant portion the infant’s skin.
What are the characteristics of vascular birthmarks?
The color of vascular birthmarks ranges from light pink to dark purple, and they can be either flat or elevated. Their size is quite variable, as well. Certain types of vascular birthmarks can evolve and change after birth.
What causes birthmarks?
Most birthmarks are probably due to defective migration of cells during fetal development. Once these cells start to multiply, they produce tissue with the characteristics of their cell type though they are not where those cells typically are located.
Are any symptoms and signs associated with birthmarks?
Pigmented birthmarks, aside from their coloration, cause no symptoms. Vascular birthmarks of certain types can produce significant symptoms. The identification of the type of vascular birthmarks may be difficult and require certain advanced imaging techniques as well pathological examination of samples of the birthmark. Certain vascular birthmarks called hemangiomas can begin as flat lesions at birth but enlarge rapidly during the first few months of life. They may ulcerate and disappear slowly, leaving only a scar. If this type of lesion is situated adjacent to an important anatomical structure like an eye or mouth, it may need to be treated to hasten the natural resolution.
What disorders are associated with birthmarks?
There are a number of rare serious disorders that are associated with both pigmented (café au lait mark, for example) and vascular birthmarks. It would be appropriate that any infant with a birthmark is examined by a pediatrician to detect any of these uncommon conditions. Some of these disorders can be inherited, so affected families need to be educated as to their significance.
Can skin damage during delivery produce a birthmark?
It is possible for birth trauma to produce sufficient damage to leave a scar. This scarring could be interpreted as a birthmark.
Birthmark Removal Treatment Procedure:
It is advisable that any newly born infant with a birthmark gets completely checked and examined by the doctors some birth marks can be associated with underlying defects.
1) Some vascular birthmarks such as stork bites usually disappear with age and do not cause any problem, hence treatment may not be required. Strawberry hemangiomas subside with age. However, if any hemangioma is associated with an important anatomical structure such as the area around the eye or mouth, and cause feeding difficulties, pressure symptoms, loss of vision, the birthmark may be required to be removed. This treatment could include oral propranolol, steroid injections, sclerosants or surgical excision.
2) Certain birthmarks, being harmless may require treatment only for cosmetic reasons. For example, large congenital melanocytic nevi, port wine stains, may lead to cosmetic disfigurement.
3) Various types of dermatological laser treatments are also available and can be utilized:
For vascular Birthmarks – vascular flash lamp pumped pulse dye laser
For dark pigmented Birthmarks – Q switched laser
4) A customized light wave that is suitable for the particular coloration of the birthmark, is used at a particular frequency. After several treatment sessions, the laser breaks down the coloration of the mark so that it fades away and blends in with the surrounding skin, without leaving any scars behind. But in many cases, the mark may not vanish completely.
5) Dermatologic surgery can also be used for the treatment purpose if excision (surgical removal) and grafting is needed.
Most commonly adopted treatments for birthmark removals are –
Q switched lasers: This treatment is recommended for dark pigmented birthmarks. The laser penetrates the epidermal and dermal layer, to break down melanocyte action and reduce melanin production. It results in gradual skin lightening and fading of pigment birthmarks.
Pulse-dye lasers: This treatment is highly effective in case of vascular birthmarks. As the culprit is vasculature and not melanocytes, the action of this treatment varies from Q-switched lasers. A good amount of intense pulse light is aimed at the area affected with birthmark to alter the malfunctioning vasculature and result in subsequent de-pigmentation.
Dermatological surgery: This procedure is adopted in case hemangioma is left undiagnosed and grows to the stage of ulceration, thereby obstructing the activity of adjoining organs. To effectively restore normal body function, surgery is recommended instead of laser treatments.
What to expect post Birthmark Removal procedure?
The purpose of the treatment is to diminish or remove the marks for medical or aesthetic reasons. After the treatment, the affected region of skin should be kept away from sunlight and UV rays. Sunscreen should be applied before stepping out. Multiple sessions ranging from 8-20 may be required based on the type of mark treated.
Vascular marks can get swelled up, ulcerated and pigmented after being treated with laser. Similarly, pigmented marks can become darker, or whitish after the laser treatment with some associated pain post procedure. Nevus of Ota has shown some of the best outcomes when being treated with lasers. At times, marks may fade away to a considerable amount, and ghost images may still remain behind. These ghost images may be concealed using cosmetic make up, or sometimes repetitive sessions of laser treatment may be required.
The treatment for birthmark removal changes drastically, based on the skin type and birthmark cause. Our procedures are based on state of the art laser technology and light wave technology. These treatments don’t provide instantaneous results, but after successive sessions which entail categorically eroding the birthmark; these treatments do deliver. The laser or light waves are focused on the birth mark affected area to slowly breakdown the melanin cluster or reposition the vascular structure in order to reduce pigmentation. Gradually the birthmark is expected to fade up-to 70-90%.
The recovery time for healing from birthmark removal is relatively short. Any swelling or discomfort will usually fade in about a week. You may notice that the treated area will become dark purple. This should disappear about ten days after the procedure but, in some cases, it can last for 6-8 weeks.
You will be advised to refrain from scratching the treated area. You should also avoid direct sunlight or use a good sunscreen when going outside in the daytime. It’s important to follow all of the doctor’s post-procedure instructions and that parents assist their children with those instructions if needed.
Birthmark removal risks are minimal. In rare cases, there may be some bruising, bleeding or scabbing. Bruising can sometimes be avoided by not taking anticoagulants such as aspirin or avoiding Vitamin E for two weeks prior to treatment. Skin tone problems can also occur. These will appear as dark or light areas on the skin. Occasionally, there may be a dark patch surrounded by lighter skin. These issues can be addressed by an additional treatment.
It should be noted that laser birthmark treatments don’t always successfully remove a birthmark. This can occur when the birthmark pigmentation is unable to be reached by the laser. Also, the darker birthmark pigmentation can rise again to the surface skin and birthmarks can reappear or even darken more. Usually, this can be effectively repaired with more laser treatments.