Vascular birthmarks are among the most common skin findings that raise both curiosity and concern. They often appear suddenly on a newborn’s skin or during growth stages without warning. Despite their noticeable appearance, their medical nature may be unclear to many people. In this article, we shed light on what vascular birthmarks are, how they form as a result of abnormal growth of blood vessels beneath the skin, and the differences between harmless types that fade over time and those that require close medical follow-up. We also review the most important treatment options available today, from laser therapy to modern medical techniques.

What Are Vascular Birthmarks?

Vascular birthmarks are skin marks or patches that appear as a result of excessive or abnormal growth of blood vessels close to the surface of the skin. They are usually present at birth or appear within the first weeks of a child’s life. Their appearance and color vary depending on the type; they may be bright red, dark, flat, or slightly raised above the skin.

In most cases, vascular birthmarks are benign and not dangerous, and many may fade on their own over time, especially in children. However, some types require medical monitoring, particularly if they grow rapidly or appear in sensitive areas.

Causes of Vascular Birthmarks

The exact causes of vascular birthmarks are not fully understood, but several possible factors may contribute to their development, including:

• Accumulation or clustering of blood vessel cells in a specific area of the skin, leading to the appearance of a vascular birthmark.
• A family history of vascular birthmarks or vascular disorders, which may increase the likelihood of their occurrence.
• Certain hormonal changes during pregnancy that may affect the development of blood vessels in the fetus.
• Imbalances in proteins that regulate blood vessel growth, such as those responsible for signaling pathways involved in angiogenesis.
• Intrauterine environmental factors, such as rapid fetal growth or minor variations in blood supply to certain areas.
• Some birthmarks appear simply as part of normal skin development in infants without any underlying pathological cause.

Types of Vascular Birthmarks

There are several types of vascular birthmarks, each differing in appearance, texture, and pattern of development. The most common include:

Strawberry Hemangioma (Capillary Hemangioma)

This is one of the most common types seen in infants. It is characterized by a bright red color and a slightly raised surface. It grows rapidly during the first months of life, then gradually shrinks and disappears without medical intervention. Despite its striking appearance, it usually does not cause health problems, and doctors typically recommend observation unless it affects vision, breathing, or feeding when located in sensitive areas.

Deep Hemangioma

This type develops in deeper layers beneath the skin, giving it a bluish or purplish appearance and a soft, compressible texture. It may not be noticeable at birth but becomes apparent as the child grows. Medical follow-up is important because it can enlarge or exert pressure on surrounding tissues. Nevertheless, many deep hemangiomas regress over time without intensive treatment.

Salmon Patches (“Angel’s Kiss”)

These are flat, pink patches that commonly appear on the forehead, eyelids, or the back of the neck and are very common among newborns. They become more noticeable when the baby cries or strains. Despite their appearance, they are among the birthmarks most likely to fade spontaneously within the first few years of life and rarely require treatment.

Port-Wine Stain

This is a flat skin patch with a dark red or purplish color, often found on the face or neck. Unlike other types, it does not fade over time and may become more pronounced as the child grows. For this reason, laser treatment is often used to improve its appearance, especially when located in visible areas. Although benign, medical evaluation is important, particularly if associated with other symptoms.

Mixed Vascular Tumors

This type combines both superficial and deep components, with a red area on the surface of the skin and a deeper bluish portion beneath. These birthmarks may grow rapidly at first but usually follow the same regression pattern as other hemangiomas. Regular follow-up is necessary to ensure they do not compress surrounding tissues or interfere with vital functions.

Treatment of Vascular Birthmarks

Treatment depends on the type, size, location, and impact of the vascular birthmark on health or appearance. In many cases, no treatment is required, as most birthmarks fade naturally over time, especially strawberry hemangiomas and salmon patches.

Medical intervention may be needed for large or deep birthmarks or those that interfere with vital functions such as vision or breathing. Common treatment options include:

• Medications: Such as beta-blockers (e.g., propranolol), which help reduce the size of the birthmark and slow its growth.
• Laser therapy: Commonly used for flat birthmarks such as port-wine stains to improve appearance and prevent color progression.
• Surgery: Rarely required and reserved for very large birthmarks or those causing significant medical or cosmetic concerns.
• Regular medical follow-up: Even without treatment, monitoring is recommended to ensure normal growth and to prevent complications affecting vital organs.

Difference Between Benign and Concerning Vascular Birthmarks

Benign Vascular Birthmarks

• The most common types, such as strawberry hemangiomas and salmon patches.
• Usually flat or slightly raised, with a light red or pink color.
• Grow rapidly at first, then gradually shrink and fade during childhood.
• Do not cause health problems or functional impairment.
• Typically require no treatment beyond routine observation.

Concerning Vascular Birthmarks

• Include deep hemangiomas or large, rapidly growing vascular tumors.
• May appear blue or purple and feel like a firm mass beneath the skin.
• Can exert pressure on important organs such as the eyes, mouth, or respiratory system, leading to health issues.
• May be associated with rare conditions requiring urgent medical care.
• Require thorough medical evaluation and may need treatment with medication, laser therapy, or surgery depending on the case.

Frequently Asked Questions About Vascular Birthmarks

When is a vascular birthmark considered dangerous?
A vascular birthmark may be concerning if it grows rapidly, changes color, appears in sensitive areas such as the eyes or mouth, causes pain or bleeding, or interferes with vital functions like breathing or feeding in children. In such cases, prompt medical consultation is essential.

What is the difference between a vascular birthmark and a hematoma?
A vascular birthmark is a skin mark caused by abnormal blood vessel growth, present at birth or shortly afterward and may last for years. A hematoma, on the other hand, is a temporary collection of blood under the skin caused by trauma or injury, appearing suddenly and resolving within days to weeks.

Do red birthmarks disappear on their own?
Yes, red birthmarks (strawberry hemangiomas) often disappear on their own. They typically appear shortly after birth, grow rapidly in the first months, then gradually shrink and fade, often disappearing completely during childhood without treatment. Medical follow-up is still recommended to ensure normal progression and absence of complications.

Conclusion

Vascular birthmarks are common skin findings and are often benign, posing no threat to overall health. Understanding their types, causes, and natural progression helps provide reassurance and ensures proper management. If a birthmark grows rapidly, changes color, or affects the function of any organ, medical consultation is strongly advised. Early observation and professional evaluation are key to maintaining health and peace of mind.