Beauty News: More Options for Treating Birthmarks Today than Ever

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Dermatologist Joshua Fox Explains Causes, Overviews Treatment for Birthmarks

Vascular birthmarks have long been surrounded by myth. Some myths have it that when a pregnant woman craves a certain food and touches her womb before the craving is fulfilled, her child will have a birthmark. Others say if the pregnant woman touches her belly during an eclipse, her baby will have a birthmark. Still others believe if the pregnant mother's wish is not fulfilled, her baby will have a birthmark. Some even believe that mothers who spilled wine on themselves when they were six to nine months’ pregnant will go on to have a baby with a birthmark.

The most common birthmarks are macular stains (sometimes called salmon patches, angel kisses or stork bites), “strawberry” hemangiomas and port-wine stains.

Birthmarks, for all their mystery and intrigue, are very common. Up to 40,000 children a year in the U.S. may be born with them, and 10 percent of newborns have them, girls five times more than boys. In most cases, they’re perfectly benign. But in others, they can be a sign of disease, from cancer to glaucoma. Hemangiomas have even been linked to low-birth weight in the U.S., and prematurity.

“Many times they are cause for psychological barriers and grief for both patients and parents,” according to Dr. Joshua L. Fox, a leading authority in the field of dermatology with an expertise in birthmarks and laser procedures.

A paper recently published at the 30th annual American Society for Laser Medicine and Surgery Conference found that a treatment for cancer may now help patients with birthmarks. Tumor growth has been found to be dependent on angiogenesis, the growth of new blood vessels. This is also how birthmarks begin. If the blood supply to both is blocked, in a process called anti-angiogenesis, tumors and blood vessels both stop growing.

Under a microscope, hemangiomas can look like a tangled mass of blood vessels. “Strawberry” hemangiomas, so named because of their pinkish hue and their typical size and shape, are benign tumors that grow on the skin.

“Depending upon their location, strawberry hemangiomas can interfere with feeding, breathing, vision or proper physical development,” says Dr. Fox. “Some hemangiomas grow inward, which rarely can affect internal organs and more commonly bleed and ulcerate. What’s more, as with all tumors, hemangiomas require a rich blood supply to survive. As babies become more mobile, a trauma to the hemangioma can cause excessive bleeding and can result in an emergency room visit.” Many hemangiomas will shrink over time on their own but some will require treatment.

Macular and port wine stains, however, rarely fade. “In fact, these flat, pinkish ‘splotches’ on the skin at birth are actually a vascular network right below the skin’s surface of malformed capillaries that often get larger, deeper, thicker and darker purple as a child grows. Port wine stains have traditionally been more challenging to treat, because they are essentially permanent congenital defects,” Dr. Fox adds. “Even as we learn new ways to destroy the capillaries, they may redevelop. Port wine stains can also be a harbinger of medical problems.”

Children born with port wine stains on their eyelids, foreheads or scalps are usually given MRIs during the neonatal period, because each year about 5% of children with a port wine stain in this general location are diagnosed with Sturge-Weber Syndrome, which can cause glaucoma and developmental delays,” according to Dr. Fox. “In rare instances, the venous system within the hemangioma becomes so large and demanding that it saps a developing child’s much-needed blood supply, taxing the heart and stunting normal growth,” he says.

Many birthmarks will shrink over time and disappear completely on their own. But sometimes treatment is called for, depending on the age of the patient, and size, location and rate of growth of the birthmark or hemangioma. Those which threaten normal development of the ear, eye, nose or mouth, or are disfiguring or rapidly growing, are usually the ones which must be treated.

Treatment options include watching and waiting, oral corticosteroids, surgical removal, and a combination of laser therapies, which can lighten even the thicker stains over time, according to Dr. Fox. In rare cases, medications used to treat cancer and high blood pressure may be used in treatment.    

Vascular birthmarks are often a shock to new parents, says Dr. Fox. “And this is understandable. But while many mothers blame themselves for their child’s birthmarks, parents can rest assured that there is no medical evidence that expectant mothers can prevent them, or that anything an expectant mother does during her pregnancy causes them. What’s more, we are better able to address these birthmarks in a way that can reduce their medical and emotional effects than ever before.”

About Dr. Fox: Joshua L. Fox, M.D., F.A.A.D., earned his medical degree from the Mt. Sinai School of Medicine in New York. He completed an internship at Maimonides Hospital in Brooklyn, followed by a three-year dermatology residency at the New York University School of Medicine. A Fellow of the American Academy of Dermatology, Dr. Fox is a leading authority in the field of dermatology, with an expertise in skin cancer, cosmetic surgery and laser procedures ( Dr. Fox has served as an expert resource on dermatologic topics for numerous television networks including ABC, CBS, CNN, NBC, Telemundo, radio stations, newspapers and magazines. He is the founder and director of Advanced Dermatology, P.C. of New York and New Jersey and the Center for Laser and Cosmetic Surgery and is a spokesman for both the American Academy of Dermatology and the American Society of Dermatologic Surgery. Dr. Fox was the founder of the AAD Melanoma/Skin Cancer Prevention Program in Queens, New York since 1987 and continues today as a director and facilitator of various prevention screening programs annually. Dr. Fox is the founder of the non-profit New Age Skin Research Foundation whose role is to persevere in providing patient education and dermatologic research information to both public and physician alike. (


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