Newborns often have temporary marks or blotches on the skin called birthmarks. While these are most often harmless and often fade or shrink on their own over time, some can be disfiguring and even potentially debilitating.

Hemangiomas, specifically, are a vascular type of birthmark that can appear either on or deep underneath the skin’s surface. Surface hemangiomas appear as bright red “strawberry marks” while those under the surface may have a blueish appearance, as they involve blood vessels in the deeper layers of skin. In many cases, small hemangiomas spontaneously shrink and disappear by the time a child is 5 to 9 years old, but larger ones may leave a scar as they regress. Others, particularly those that appear on the face or neck, may be large enough to interfere with vision or block the nose or mouth. In these cases, prompt treatment is necessary in order to remove the obstruction and minimize long-term appearance deficits.

At Children’s, our team of pediatric surgeons has conducted several long-term birthmark treatment studies involving the use of intralesional laser treatments to reduce the size of capillary hemangiomas. While the use of external laser light, applied to the surface of the mark to shrink the blood vessels supplying blood to the area, has been used effectively for years, its limited ability to penetrate deep beneath the skin restricts its usefulness in cases where there is a deeper cavernous component or a completely subcutaneous lesion.

By using a form of fiber optic technology to introduce the laser energy to deeper levels of the skin, we have been able to consistently achieve significant reductions in both the diameter and thickness of the lesions with an extremely small incidence of post-treatment complication. In particularly severe cases, where laser treatment has either proven ineffective or is not a viable option, surgical excision may be necessary to remove either the lesion or the scars that may result from it. Scar revision or autologous fat transfer techniques can also be used to rebuild the area and help achieve a more aesthetically pleasing appearance.

Related research publication

  • Burstein, F.D., Simms, CA., Cohen, S.R., Williams, J.K., Pascal, M.: “Intralesional Laser Therapy of Extensive Hemangiomas in 100 Consecutive Patients.” Annals of Plastic Surgery. 2000 Feb;44(2);188-94.

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Visit PubMed for additional research publications by Dr. Williams

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