Vascular malformations or anomalies, like haemangiomas, are abnormalities of blood vessels. Unlike haemangiomas, they are usually present at birth and do not disappear with time.
Haemangiomas or strawberry naevi, often appear on the skin as a bright red mark. Usually they appear shortly after birth within the first month of life and then increase in size quite quickly.
Most haemangiomas then reach a stable phase where they stay the same size for several months to a few years. Following this, most strawberry birthmarks gradually regress and many disappear completely.
There are many different types of vascular malformations and they are classified according to the types of vessels from which they are made.
Frequently Asked Questions
Port Wine Stains
These birthmarks commonly involve the face and give the skin a red, wine or purplish colour. They consist of dilated small blood vessels beneath the layer of the skin. They are occasionally associated with other conditions. Laser treatment can be very effective for treating the visible effects of port wine stains.
Venous malformations consist of an area of abnormal veins. They can vary greatly in appearance and if they require treatment, are often treated by sclerotherapy or surgery.
Arterial and Arterio-venous Malformations
These malformations involve abnormally connected arteries and veins and can be very difficult to treat. Embolisation, interventional radiological techniques and surgery may all have a role to play in the management of these lesions.
These malformations involving the lymph system are also called lymphangiomas or cystic hygromas. Their appearance and effects are very variable and there are many surgical and non-surgical ways of treating them. Treatment of complex vascular anomalies needs to be undertaken by a multidisciplinary team including plastic surgeons, dermatologists, interventional and diagnostic radiologists, clinical nurse specialists and sometimes orthopaedic and paediatric surgeons. Professor Dunaway is a member of the Vascular Anomalies Team at Great Ormond Street Hospital for Children in London.
Haemangiomas commonly grow on the face. If they are close to the eye, they may interfere with visual development. Haemangiomas forming on the lips or nose can cause airway or feeding problems. In these cases, treatment is required and may consist of prescribing propranalol, laser treatment, steroid therapy or surgery.
Most Strawberry marks reach their final size by 3-9 months of age. The speed and timing of regression is very variable. The following figures give a rough time scale to their disappearance;
- 30% of them will have faded by the 3rd birthday
- 50% by the 5th birthday
- 70% by the 7th birthday
Most haemangiomas do not require treatment. Occasionally however, there can be troublesome bleeding from the surface of a haemangioma, which may require special dressings. If there is persistent bleeding from the surface, laser treatment can be effective in reducing this problem. Rarely, propranalol, steroid therapy, sclerosing therapy or surgery is used for their treatment.