Many birthmarks fade over time and require no treatment. Some birthmarks, such as cafe-au-lait and Mongolian spots usually do not fade—however, they do not need treatment. If a birthmark develops in an area that makes a child self-conscious, makeup can be used to cover it. When a child's birthmark needs no treatment, a health professional often can tell a parent what to expect—whether it will grow, shrink, or fade—and can help parents with other issues relating to the
birthmark. Other birthmarks, such as certain hemangiomas, may need treatment. Treatment for hemangiomas varies depending on the type, size, rate of growth, and location. For example, a fast-growing hemangioma near a child's eye needs to be treated, as do those that are expected to leave significant marks. Hemangiomas on internal organs always need treatment.
Many of the more conventional treatments to remove or diminish the appearance of birthmarks involve long and sometimes painful processes. The use of corticosteroid medications carries a number of risks. Cryosurgery (freezing off the birthmark) has limited applicability. Surgery and treatment with ablative lasers can cause scarring and harm nearby healthy skin. Fortunately, new laser and IPLTM-based therapies are allowing physicians to successfully treat many types of unsightly birthmarks and pigmentation simply and non-invasively. It's important that prospective patients consult with a physician to determine the most appropriate treatment.
Other birthmarks, such as certain hemangiomas, may need treatment. Treatment for hemangiomas varies depending on the type, size, rate of growth, and location. For example, a fast-growing hemangioma near a child's eye needs to be treated, as do those that are expected to leave significant marks. Hemangiomas on internal organs always need treatment.
Treatment for hemangiomas includes:
Corticosteroids such as prednisone. Corticosteroids can be taken as pills or injected directly into a hemangioma to shrink it or to stop it from growing. Side effects of corticosteroids (such as weight gain or round face) usually disappear after treatment is stopped. In rare cases, if corticosteroids do not help reduce or stop the hemangioma from growing, other substances that reduce the size of tumors (such as interferon alfa-2a) may be used.
Laser therapy. Lasers often are used to treat birthmarks that are close to the surface of the skin, such as port-wine stains. Sometimes using laser therapy to treat a growing hemangioma stops it from growing, but laser therapy may not work to treat deeper hemangiomas. Laser therapy can be done at any age.
Surgery. A hemangioma needs to be surgically removed when other treatments have not worked or when the hemangioma is on an internal organ. Surgical removal of a hemangioma may leave a scar, which may need to be removed or faded with other treatments.
The nevus flammeus type of hemangiomas may require no treatment unless they are disfiguring or psychologically distressing, or unless they develop new qualities like becoming painful or changing appearance. Permanent lesions may be disguised with cosmetics, especially cosmetics designed to be concealing or covering (such as Covermark). Oral or injected cortisone may be used to reduce the size of a hemangioma that is growing rapidly and obstructing vision or vital structures.
Permanent birthmarks may be treated with cryotherapy (freezing), surgical removal, or laser surgery. They are usually not treated unless they cause unwanted symptoms, or until a child is at least school age. However, port wine stains on the face should be treated at a young age with a yellow pulsed dye laser for best results and to prevent the often profound psychosocial problems caused by the port wine stain.