FIRST QUARTER 2006, VOLUME 20, NUMBER 1

Ask the Surgeon

IN THIS ISSUE

Skin Blemishes, Birthmarks… Embrace, Conceal, or Remove

Your neck tells all… here’s how you rejuvenate and improve its appearance

Ask the Surgeon / Health Tip / What’s New

Complementary services boost patient satisfaction and care

Birthmarks are apparent in over 10 percent of all children born.

These may sound familiar-stork bites, angel kisses, strawberry marks, port wine stains, moles, café au lait spots, and lentigines. Birthmarks are either vascular (related to blood vessels) or pigmented (related to melanin). Find out what characterizes the different blemishes and what treatment options you have.

Vascular birthmarks, hemangiomas, are made up of blood vessels clustered together in the skin and can be flat, raised, pink, red, or bluish in color. Stork bites are small, faint, red stains that usually appear on the nape of the neck. Angel kisses are similar marks that appear on the child’s forehead, eyelids, nose, and upper lip. Stork bites and angel kisses often lighten considerably with age or fade altogether. Strawberry marks are a collection of dilated capillaries that appear as bumpy, red blemishes. This type of birthmark will increase in size for a time, then shrink gradually and often disappear altogether by the time the child is seven. In cases where hemangiomas are not decreasing in size, steroids may be injected or given by mouth. Long-term or repeated treatment may be necessary. Lasers may also be a consideration for removal or to control the growth. Port wine stains, another common hemangioma, are enlarged blood vessels under the skin that produce reddish to purplish discoloration, most often on the face. Port wine stains are present at birth (occurring in three percent of births), and deepen in color and increase in size with age. These birthmarks can affect a person emotionally and socially, especially when they are noticeable on the face. Treatment may include camouflage makeup or laser surgery.

The second type of birthmark is the pigmented birthmark, i.e., moles, café au lait spots, and lentigines. Unlike hemangiomas, these are composed of abnormal clusters of pigmented cells and not clusters of blood vessels. Moles usually appear after birth and may be tan or brown in color. Those that appear at birth have a higher risk of becoming skin cancer, especially if it covers a sizeable area.

If you have pigmented birthmarks that are rather large, you should have a physician check them on a regular basis. Any sudden color change, pain, or bleeding, should warrant a visit to your doctor. Surgical removal of the lesion is the preferred treatment in cases where the mole has a high risk of becoming malignant. Laser surgery, surgical scraping, and cryotherapy (freezing) are not permanent solutions. The lesion will reappear eventually. Medical treatment is not necessary if the birthmark degenerates over time.

If your birthmark is desired and admired, it is still a good idea to have it checked out. If not, make an appointment with your facial plastic surgeon to discuss your aesthetic and medical concerns and the best mode of concealment.