Advice on birthmarks from Professor John Harper
New service: birthmarks
This summer saw the launch of our children’s birthmark service which complements the comprehensive paediatric dermatology provision already offered at The Portland Hospital. The service is led by Professor John Harper, supported by a dedicated Clinical Nurse Specialist and a wider team of Consultants covering plastic surgery, otolaryngology, orthopaedics, ophthalmology, audiology and interventional radiology. Prof John Harper explains more:
“The service will provide expert information and advice to parents about their newborn baby. Birthmarks are extremely common, affecting up to four out of five babies. The majority occur as minor developmental imperfections of the skin and are completely harmless to the baby’s health. For most birthmarks nothing needs to be done apart from reassurance; however some may require further investigation and treatment.”
The multidisciplinary service encompasses the following:
Neonatal Skin Screening: all babies born at The Portland Hospital are screened for birthmarks and any birthmarks which may alert concern are examined by Professor Harper and a discussion held with the parents. This service is also available to newborns that have not been born at The Portland Hospital.
Propranolol treatment: The Portland Hospital is proud to be leading the way with a pioneering new birthmark treatment using propranolol. This has replaced the traditional treatment for haemangiomas which until now has been steroids. Propranolol, a beta-blocker recently discovered to be highly effective in shrinking infantile haemangiomas, is now recognised to be the treatment of choice for haemangiomas requiring systemic treatment. It is administered in the Hospital’s Day Case Unit under medical supervision.
Skin Laser Service: The pulsed dye laser, the Vbeam Perfecta® provides treatment for vascular skin lesions, in particular port wine stains, telangiectasia (spider naevi) and ulcerated haemangiomas. Facilities are available for both general anaesthesia and local anaesthesia, depending on the age of the child and the size of the vascular lesion.
As birthmarks are common and can present in many different forms it can be difficult to determine when to refer for a specialist opinion. Professor Harper offers the following advice:
- Haemangiomas which may give rise to complications or significant disfigurement should be referred early so that treatment with propranolol can be started within the first weeks of life, if appropriate.
- Port wine stains on the forehead and scalp may be associated with brain problems, known as Sturge-Weber syndrome, a condition which is associated with seizures and glaucoma. Early referral will provide the parents with expert advice on a strategy of management.
- Port wine stains respond well to laser treatment. The procedure needs to be discussed with the family and treatment is usually started from around one year of age, if not earlier. There is good evidence that early treatment produces better results.
- Café au lait spots may occur anywhere on the body. These birthmarks may be present at birth, or appear in early childhood; one or two is common, but six or more may be an indicator of an underlying genetic disorder, in particular neurofibromatosis.
- Moles (congenital melanocytic naevi) are visible on one in a hundred newborns. 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.
Professor Harper is speaking about birthmarks at The Portland Hospital’s GP Allergy Symposium in January, further details about the Symposium including how to book a place can be found here.
The following Consultant Dermatologists hold outpatient clinics at The Portland Hospital:
Professor John Harper
Dr Nerys Roberts
Dr Mary Glover
Dr Tabi Leslie