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Birthmarks

The Portland Hospital’s Birthmark Service is led by one of London’s leading Dermatologists, Professor John Harper who also holds an NHS post at Great Ormond Street Hospital.

The Birthmark Service is supported by a dedicated Clinical Nurse Specialist and a wider team of specialists with expertise in plastic surgery, orthopaedics, ear, nose and throat, ophthalmology, audiology and general paediatrics to provide a multidisciplinary approach to care. .  A clinical psychologist is also available for the family if needed. The team will provide support at all stages to ensure a seamless patient journey.

We also have excellence in radiology to provide the very best facilities for ultrasound, MRI, and CT imaging as well as interventional radiology


Our Treatments

Our team leads the way in offering the latest treatments for birthmarks. These include the use of the beta blocker drugpropranolol to shrink haemangiomas (strawberry marks) and pulse dye laser treatments for port wine marks, available with local or general anaesthesia.


About Birthmarks

Birthmarks are extremely common, affecting up to four out of five babies. The majority occur as a minor developmental imperfection of the skin and are completely harmless to the baby’s health. They appear in various shapes, sizes and colours depending on the tissues (cells) involved. The most common causes are abnormal blood vessels (vascular birthmarks) or pigment cells forming in clusters (pigmented birthmarks). As visible marks on the skin, they range from pink to dark brown, develop in utero and are present at or soon after birth.

For most birthmarks nothing needs to be done apart from reassurance; however; some may require further investigation and treatment. In rare cases, certain birthmarks can be associated with more serious medical complications and in these cases early intervention is needed.

In some cases though, birthmarks can be more troublesome – particularly if they are very large or interfere with your child’s sight, breathing or feeding. In those cases treatment may be needed.

The birthmarks seen by Professor Harper and his team are listed below:


Vascular Birthmarks

STORK MARKS / SALMON PATCHES
This is the most common birthmark (affecting one in five babies) and is seen as a flat red mark on the skin on the upper eyelids, mid-forehead and on the back of the neck. Treatment is not necessary and usually the marks on the face will fade and by the age of two are likely to be hardly visible. The red area on the back of the neck will persist relatively unchanged throughout life but will be covered by hair and will not pose a cosmetic problem.

STRAWBERRY MARKS (Haemangiomas)
These affect one in ten babies and may be present at birth as a pale or pink area of skin, but often it becomes apparent during the first week of life as a red or purple lump  which rapidly grows over a three to six month period. Thereafter it slowly regresses spontaneously and eventually will disappear almost completely in three to seven years. For the majority of haemangiomas no treatment is necessary; however, they can potentially pose a problem at certain sites on the body, for example around the eye or internally in the airway, and the treatment of choice for these babies is a beta blocker  drug called propranolol (see below) which is administered as a medicine.

PORT WINE STAINS
These are permanent red flat marks which can occur anywhere on the body, often on one side of the face. They affect three in a thousand babies. Unlike strawberry marks port wine stains do not become less noticeable in fact with out treatment they may become thicker and darker. If left untreated they can cause a significant psychological problem especially those on the face.

The good news is that these birthmarks respond well to laser treatment with good long term evidence that these secondary skin changes are unlikely to occur post laser treatment. The earlier laser treatment is started the better the result.  For most children laser treatment of a port wine stain starts when the child is around one year old. A course of  4-6 treatments performed over several years can fade port wine marks in three quarters of children treated.


Pigmented Birthmarks

The majority of pigmented birthmarks don’t need any treatment. For instance Mongolian spots which are blue/grey spots that affect babies with darker skin will usually disappear on their own by the age of four.

CAFÉ AU LAIT SPOTS
These coffee coloured skin patches are only a cause for concern if your child has a lot of them (defined as six or more by the age of five). In those extremely rare cases it could be a sign of an underlying genetic disorder, in particular neurofibromatosis.   

CONGENITAL MELANOCYTIC NAEVI
These are brown or black moles, fairly common and caused by an overgrowth of pigment cells.  They range in size and colour, usually light brown in fair-skinned babies and almost black in darker-skinned babies. The vast majority have no medical concern but very rarely they may be extensive (giant congenital melanocytic naevi) which can be associated with neurological involvement and a recognised low malignancy risk.


For more information about how The Portland Hospital’s Birthmark Service can help your child please call Professor Harper’s office on 0207 390 8308.

Please also view the following: Birthmark Leaflet (PDF)

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