Types of Vascular Birthmark
Infantile haemangiomas ("strawberry marks") are the most common vascular birthmark. They are usually not present at birth, appear in the first weeks of life, grow over several months (the proliferative phase), then gradually fade and shrink over several years (involution). Most require no treatment beyond observation.
Capillary malformations (port-wine stains) are present from birth, do not grow, and persist throughout life without treatment. They are caused by abnormally formed blood vessels in the skin, not a growth.
Venous and lymphatic malformations are less common and are assessed and managed individually, often with input from a specialist vascular anomalies service.
When Assessment or Treatment Is Recommended
- Haemangiomas near the eye, airway or other functionally sensitive sites, where growth could threaten function
- Ulcerated or bleeding haemangiomas
- Large or rapidly growing lesions
- Residual fibrofatty tissue or skin change remaining after a haemangioma has involuted
- Port-wine stains, where laser treatment can reduce colour and are usually most effective when started early
Treatment Options
Problematic infantile haemangiomas are most often managed medically in the first instance — propranolol is the established first-line treatment where treatment is indicated, prescribed and monitored as part of coordinated paediatric care. Port-wine stains are typically referred for pulsed dye laser treatment through a specialist paediatric dermatology or laser service. Mr Naparus's direct surgical role is most often in excision of residual fibrofatty tissue once a haemangioma has fully involuted, or surgical management of selected vascular lesions where appropriate — assessed and discussed individually at consultation, with referral to the relevant specialist service arranged where medical or laser treatment is the right first step.
Assessment
Assessment considers the type, site, size and growth pattern of the lesion, and its potential to affect function (vision, breathing, feeding) or to cause ulceration. Rarely, extensive facial vascular birthmarks warrant further investigation for associated syndromes, which would be discussed and arranged as part of a wider assessment.