Many birthmarks are harmless and require no treatment at all. Either they fade as a child grows or remain on the skin but pose no health risk.
Other birthmarks may grow very quickly. Without medical treatment, they can become large, permanent areas of discoloration that may affect deep layers of skin. If a birthmark is located in a highly visible place, parents may elect to minimize its appearance while a baby is young.
Dermatologists at Hassenfeld Children’s Hospital at NYU Langone offer specific treatments for different types of birthmarks and partner with parents to create a treatment plan that is customized to your child’s needs. Medication and laser therapy can be very effective in reducing the size of birthmarks and in preventing them from becoming permanent.
Propranolol is a medication taken by mouth that can be very effective in reducing the size and lightening the color of hemangiomas, which are vascular birthmarks caused by improperly formed blood vessels. Propranolol inhibits the growth of new blood vessels within hemangiomas and shrinks existing blood vessels.
Our dermatologists may prescribe propranolol if a hemangioma is located in the airway or near the eyes or mouth, and threatens to interfere with functions such as vision or breathing. A doctor may also prescribe this medication to shrink a hemangioma for cosmetic purposes.
Propranolol is available as a liquid medicine and is taken two or three times per day throughout the first year of a baby’s life, when hemangiomas usually grow more aggressively. These birthmarks often become smaller or lighter in color within weeks.
After the first year of treatment, dermatologists assess the size and color of a hemangioma before recommending additional treatment. The goal of treatment with propranolol is to continue therapy until the hemangioma is no longer growing and to gradually end treatment as soon as possible after one year. However, ending treatment too soon may result in regrowth.
Our dermatologists monitor your child during regular office visits to determine the best time to end treatment.
If a hemangioma develops on a sensitive area where the skin is thin, such as an eyelid, dermatologists may prescribe a topical medication called timolol. Like propranolol, timolol causes the birthmark to shrink and fade by preventing new blood vessels from forming and making existing blood vessels smaller.
This medication is a gel that parents apply directly to the birthmark, generally twice daily, throughout the first year of a baby’s life. The amount of gel applied and the length of time the medication should be used are determined by our dermatologists based on the size of the birthmark. Many people see significant improvement in the size and appearance of hemangiomas within weeks.
Laser treatment uses highly focused beams of light to reduce the size and lessen the color of birthmarks. This includes red birthmarks, such as strawberry hemangiomas and port wine stains; brown birthmarks, such as café au lait spots; and blue birthmarks, such as facial dermal melanocytosis.
Our dermatologists use a machine called a vascular laser or pulsed dye laser to eliminate blood vessels without damaging the surrounding skin.
When the laser light enters the skin tissue, it is converted into heat and eliminates blood vessels. For birthmarks that are brown or blue, the laser is used to target and decrease melanin, the substance responsible for skin pigment.
Laser therapy typically takes place in a doctor’s office, and sessions last between 15 minutes and 1 hour, depending on the size and number of birthmarks to be treated. Several treatment sessions may be required to lighten birthmarks that are large or darker in color. Our dermatologists recommend scheduling treatment sessions at least four weeks apart to allow the skin to heal fully in between sessions.
Recovery from laser therapy is minimal. Your child may have slight bruising after treatment, but this is not painful and fades in a few days.
Special care should be taken to protect your child’s skin from sunlight after laser therapy sessions. Dermatologists may recommend covering the affected area with sunblock that has SPF 30 or higher. They may also suggest covering the area with a bandage.
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