Strawberry Hemangioma

From stork bites to port wine stains, newborns and infants can have a variety of marks and spots on their bodies. Depending on their size, shape, color, and location, some of these normal infant skin conditions can be shocking. One such mark that can be scary and upsetting to see growing on your baby is the strawberry hemangioma. What is it, and is it dangerous? Here’s what you need to know about strawberry hemangiomas including how they grow, what to watch for, and how to treat them.

What It Is 

A strawberry hemangioma is also called an infantile hemangioma, strawberry mark, or strawberry nevus.

Then, after the baby is born, the clump grows. 

Infantile hemangiomas are red or pink patches on the baby’s skin that can be flat or raised. They are called strawberry marks because they sometimes look like a strawberry. These growths can be small or quite large. They commonly appear on the head and neck but can also be found on the torso and limbs or anywhere else on the baby’s body. 

When It Appears and Goes Away

Your baby can be born with a strawberry hemangioma, but it is more likely to show up in the first few weeks after birth. It commonly appears in the first month as a tiny mark that looks like a small bruise or a pale spot on the skin. During the first three to six months, an infantile hemangioma can grow very quickly, getting redder as it grows.

The growth typically slows down after six months but can continue until the baby is nine to twelve months old. Then, between one year and 18 months, the hemangioma may begin to flatten out, shrink down, and fade. Although it could take longer, many go away by the time the child starts school at age five. And, almost all go away by the time the child is ten. 

Causes

Infantile hemangiomas are very common. Studies show they affect approximately 4 to 5% of babies or up to 1 in 20. Experts do not know why some babies get infantile hemangiomas, but researchers found that hemangiomas are more likely to show up in babies who are: 

• Caucasian (white) children
• Girls
• Low birth-weight 
• Premature
• Twins
• Firstborn children
• Breech

They are also more likely in these situations: 

• Advanced maternal age
• Preeclampsia
• Placenta previa
• Use of fertility medication
• Family history

Researchers are learning what doesn’t cause hemangiomas, as well. There is currently no evidence that they are caused by any food, activity, or environmental exposure during pregnancy.

Diagnosis

The doctor may notice the hemangioma at one of your baby’s well visits, but you’re more likely to notice something on your baby’s skin first. If you see something, be sure to point it out to the doctor so the doctor can monitor it as it grows then fades. The pediatrician can often follow the hemangioma, but you may also see a pediatric dermatologist. 

The doctor may be able to give you a diagnosis just by examining the baby and the spot. However, he may order other tests such as an ultrasound or MRI.

Concerns

A strawberry hemangioma may appear and grow like a tumor, but it's not cancer and will not spread like cancer. While there's usually no need to worry and complications are rare, there are a few things you can watch for. Notify the doctor if: 

• It is growing very fast and very quickly. 
• It is interfering with your baby's breathing.
• It is on the baby's eye and blocking her vision.
• It is bleeding regularly.
• It looks infected.
• There are many hemangiomas on the baby's body.

Treatment

If the hemangioma is just a cosmetic concern and not a medical concern, you can usually let it fade and go away naturally. However, your doctor will talk to you about treatment based on:

• Where the hemangioma is on your baby's body
• How fast it is growing
• How big it is 
• How likely it is to cause complications 
• How many there are 
• Your baby's age
• Your feelings about the mark and the treatment plan

Of course, you may not have a choice about treatment. It is necessary if the hemangioma is getting in the way of your baby's health or development, and its size and location are causing a problem with: 

• Breathing. A growth on the throat or near the larynx can block the airway and make it difficult to breathe.
• Vision. Most of the time, a strawberry hemangioma near the eye is not dangerous and will not affect your baby's eyesight or the development of the eyes. But, if it does, the doctor will recommend treatment. 
• Eating or Talking. A big hemangioma on the baby's mouth might cause an issue with eating or with speech as your child learns to talk.
• Elimination. Hemangiomas in the diaper area can affect the baby's ability to move his bowels or urinate freely. 

Treatment for strawberry hemangiomas include: 

• Observation 
• Compression
• Oral medicines such as propranolol or corticosteroids 
• Injections with steroid medicine
• Freezing (cryotherapy) with liquid nitrogen
• Laser treatments
• Surgery

Some leftover marks may need additional treatments or surgery to repair. A scar or leftover mark can also remain after medication, injections, laser treatments, or surgery. However, a skilled doctor and the right treatment can help keep scarring to a minimum.

Complications

Generally speaking, strawberry hemangiomas are not a reason to worry. However, if you notice any mark or growth on your baby, it is always wise to have it checked out by the doctor. Complications are very rare, but they can happen. The problems that can develop from a strawberry hemangioma are:  

Bleeding: Sometimes, a strawberry hemangioma will get bumped, scratched, or injured causing it to bleed.

Open Sore: An open sore is called an ulcer. An ulcer can form from rubbing or injury. Ulcers can cause other complications such as pain, bleeding, infection, and scarring.

Infection: Bacteria can enter the body from an opening in the skin.

Pain: Hemangiomas are not painful for your child. However, they can become painful if they grow large and interfere with a body function, the skin breaks down, or they become infected. 

Underlying Condition: If there are many hemangiomas, the doctor will do further testing to check for a health issue.

Scarring: Hemangiomas can leave behind a scar. Scarring is more likely if there was an ulcer, injury, bleeding, or an infection. Sometimes treatment can also cause scarring. 

How to Cope When Other People Stare

When your child has a visible birthmark on her face, ears, neck, head, or arms, one of the hardest things you may have to deal with is other people’s reactions. Unfortunately, some people will stare, point it out, or ask questions without taking a moment to think about it first.

It is natural to want to protect your child, so dealing with other people’s knee-jerk reactions to your child’s appearance can be difficult. But, you can get through it. Here are some ways to deal with it.

Try to be Understanding

Some people, especially children, are just curious and not trying to be rude or judgmental at all. They may not even realize they were looking a little too long and could only be trying to understand what they are seeing. If you think about it, you have probably done it, too. 

Smile and Wave at Them

Make eye contact and smile at whoever is staring. They may get embarrassed and look away quickly, or they may smile back at you and your baby. 

Say Hello

It’s OK to say hello and interact with people who are staring. You can ask them if they have any questions for you and take the opportunity to educate them on your child’s condition. It might even save another family from the dreaded stare.

Ignore Them

Some people are just rude, and there’s nothing you can do. Take a deep breath, walk away, and forget about them. 

Don't Let it Get to You

Don’t let other people prevent you from going out with your child and enjoying the time that you spend together. It’s really their issue, not yours. 

Cherish Your Child

Your child is precious and beautiful just the way he is. There is nothing anyone can say or do to change how much your child means to you. Go out, take pictures, and do all the things you normally would. 

Look for Support

Friends and family who love you and your child are a great source of support to help you through. Other moms who have been through it can also be helpful, especially in the beginning. 

Hang in There

It can be really tough sometimes. But, remember that the hemangioma will not be there forever. It will go away eventually. 

Emotional Health

Some parents want to have the mark treated even if it isn't causing a health issue. A strawberry hemangioma on the baby's face can be upsetting because it changes your baby's appearance. If it is disfiguring it could cause emotional distress for the child. 

When the hemangioma is on the body, you can hide it behind clothing. But, when it's on the face, it is easily seen. As the child grows and begins school and other activities, a different appearance can lead to bullying or difficulty making friends. When thinking about treatment, it is important to consider how the hemangioma may affect the child's self-esteem and future experiences.

A Word From Verywell

Strawberry hemangiomas can give you a scare when they first start to grow. And, dealing with the change in your baby’s appearance and other people’s reactions to it can be difficult. But, thankfully, they are almost always harmless and painless, and rarely cause complications. It may feel like an eternity, but hemangiomas usually begin to shrink after about a year and most go away on their own. So, look to your support system, and see your baby’s doctor to ask questions, get the most up-to-date information, and make a personalized plan for your baby’s needs.