Birthmarks (Hemangiomas & Vascular Birthmarks)

Types of Birthmarks

Vascular Birthmarks

Infantile Hemangiomas (Strawberry Marks) Bright red, raised, soft tumors that appear within the first weeks of life, grow rapidly in months 1–5, then slowly involute over years. Treatment with oral propranolol is indicated for:

• Facial lesions (cosmetic/functional risk)
• Airway involvement
• Rapidly growing or ulcerating lesions
• Kasabach-Merritt phenomenon

Port-Wine Stains (Capillary Malformations) Flat, pink-to-deep-red birthmarks that persist and darken with age. Associated with Sturge-Weber syndrome (facial port-wine stain + brain/eye involvement). Treated with pulsed dye laser (PDL) — best outcomes with early treatment.

Salmon Patches / Nevus Simplex ("Angel Kisses" / "Stork Bites") Faint pink patches on the eyelids, forehead, or nape of neck — most fade by age 2.

Pigmented Birthmarks

Congenital Melanocytic Nevi (CMN) Brown-to-black birthmarks varying from small (< 1.5 cm) to giant (> 20 cm). Giant CMN carry increased melanoma risk. Regular monitoring and, for large lesions, possible staged excision is recommended.

Café-au-Lait Macules Light brown flat spots — multiple lesions (> 6) may indicate neurofibromatosis type 1.

Mongolian Spots (Dermal Melanocytosis) Blue-gray patches on the lower back/buttocks of infants, common in darker-skinned individuals. Fade in childhood.

Treatment at Miami Skin Center

• Oral propranolol coordination for hemangiomas
• Pulsed dye laser for port-wine stains and vascular birthmarks
• Surgical consultation for large or atypical pigmented nevi