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While the vast majority ofÂ haemangiomas automatically shrink afterÂ a year,Â some mayÂ leave the skin deformed or stretched. In these cases, plastic surgery may be an option to improve the appearance of the distorted skin. For more information, go to Health A-Z: plastic surgery.
If the haemangioma is complicated or large, you may be offered medication. This isÂ usually the beta-blocker propranolol (see Health A-Z: beta-blockers).Â If your haemangioma has formed an ulcer, you may be offered surgery or laser treatment (see below).
Complicated or largeÂ haemangiomas
Some haemangiomas may cause complications that willÂ need treatment.
A haemangioma near your child's eye, nose or mouth may cause problems with vision, breathingÂ andÂ feeding. Haemangiomas on the lip or around the nappy area are more likely to form ulcers, which sometimes bleed and can be painful.
The exact method of treatment will depend on the severity and location of the haemangioma. For example, if the haemangioma affects your child's vision, they will usually need to take propranolol, in liquid form. This will shrink the birthmark.
If your child has breathing difficulties because of a haemangioma in the airway, they may need to have laser treatment during a microlaryngoscopy and bronchoscopy (a test that allows the doctor to look into your childâs airway using a small telescope, known as an endoscope). They may also be given propranolol. For more information, go to the NHS leaflet onÂ microlaryngoscopy and bronchoscopy.
YourÂ child may need to have aÂ tracheostomy (artifical opening into the windpipe) to improve their breathing.
Monitoring internal haemangiomas
If a haemangioma is present in your child's internal organs,Â they may need to have anÂ ultrasound scan orÂ magnetic resonance imaging (MRI) scan. An MRI scan uses a strong magnetic field and radiowaves to produce detailed pictures of the inside of your body.
Port wine stains
Port wine stains are permanent. The treatment options are:
- pulsed dye laser treatement, which can fade the mark, and
- camouflage make-up, which can disguise it.
Infants with port wine stains should be offered pulsed dye laser treatment early on, because the vessels are thinner at this stage and respond better to the treatment.
Pulsed dye laser treatment
Pulsed dye laser treatment lightens the affected area of skin, and it is the best treatment for a port wine stain.
The laserÂ passes throughÂ a fibre optic cable. On the end of the cable is a device that looks like a pen. This is held gently against the surface of your childâs skin, and a button is pressed, which sends a shot of light to the skin.
The light goes less than 1mm into the skin. It is absorbed by the blood vessel just beneath the surface, which causes it to heat up. The heat damages the blood vessel, which creates a bruise, but this will fadeÂ withinÂ a week orÂ two.
During and/or after treatment, your childâs skin is cooled to reduce discomfort. AÂ jet of cold air is blown onto the skin during treatment.
A local anaesthetic (to numb the area around the skin), such as an anaesthetic cream, is used in older children. A general anaesthetic (where you are put to sleep) is used for younger children.
The side effects of laser treatment are minimal.
Up to 10 treatment sessions may be needed at intervals of three to four months.
The treatment's effectiveness will depend on how prominent and dark the affected area is.
- If the birthmark is superficial (shallow), the mark may be hardly noticeable after treatment.
- If the birthmark is dark to begin with, the mark may still be visible after several treatments.
Port wine stains tend to come back afterÂ laser therapy is completed (after two to four years), therefore further treatment will be needed.
For more information, read the NHS factsheet onÂ pulsed dye laser treatment.
You can get a prescription forÂ a special type ofÂ camouflage make-up, which will cover up the birthmark.
Go to theÂ Red Cross website for expert advice. It has specialist skin camouflage clinics around the country, or visit any of the charities listed in the Useful links, right.
Salmon patches (stork marks) are blemishes that often disappear a few months after birth, so they do not need to be treated.view information about Birthmarks on www.nhs.co.uk »
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