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While the vast majority of haemangiomas automatically shrink after a year, some may 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 is usually the beta-blocker propranolol (see Health A-Z: beta-blockers). If your haemangioma has formed an ulcer, you may be offered surgery or laser treatment (see below).

Complicated or large haemangiomas

Some haemangiomas may cause complications that will need treatment.

A haemangioma near your child's eye, nose or mouth may cause problems with vision, breathing and 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 child’s airway using a small telescope, known as an endoscope). They may also be given propranolol. For more information, go to the NHS leaflet on microlaryngoscopy and bronchoscopy.

Your child may need to have a tracheostomy (artifical opening into the windpipe) to improve their breathing.

Monitoring internal haemangiomas

If a haemangioma is present in your child's internal organs, they may need to have an ultrasound scan or 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 laser passes through 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 child’s 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 fade within a week or two.

During and/or after treatment, your child’s skin is cooled to reduce discomfort. A 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 after laser therapy is completed (after two to four years), therefore further treatment will be needed.

For more information, read the NHS factsheet on pulsed dye laser treatment.

Camouflage make-up

You can get a prescription for a special type of camouflage make-up, which will cover up the birthmark.

Go to the 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

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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