“Share our similarities, celebrate our differences.”  M. Scott Peck

There are many people walking around with birthmarks. They vary in size, colour and placement. Depending on it’s location and it’s size, some people may be insecure about having one. They may look for removal or camoflauge while others see it as part of them and would feel naked without one. It all depends on the person. Everyone’s decisions are very different and as a parent it is difficult to make a decision for your child who can’t yet voice their own opinion.

Lets start with parental guilt.

When your child is born with a Port Wine Stain (PWS) it is natural to be a little upset or worried.  We all subconsciously count all of our baby’s fingers and toes to make sure they are all there. We want our babies to be perfect, I mean after all. If they start out perfect, maybe we can keep them that way. Of course this can never happen. Nobody is perfect and we certainly can’t expect him or her to be. Once we realize this is impossible, the overpowering guilt seems to creep in; you feel guilty for wishing it away and then you think, “maybe I did something during pregnancy.” “ If only I had known I was pregnant sooner and didn’t have that glass of wine”, or “I should have taken it easier, I was always rushing around”. Relax, it wasn’t anything you did. It just happens, and there is no known reason for it. There are many studies going on to try to determine why it happens… but lets leave that up to the scientists to determine. Not our overactive imaginations. Besides after a while, you wont be able to imagine your child without it and will love that birthmark just as much as those ten fingers and toes.

Your job as a parent is to find out what kind of birthmark your child has and if there is anything else attributed to having that particular mark. For the most cases there isn’t anything there other than simply a beautiful spot of colour.  But to ease our minds as parents we need to know for sure that is all it is. To determine what kind of birthmark it is, you’ll have to go to your doctor for them to see for him or herself. There is a lot of self-diagnosis done over the internet these days and I know from first hand experience that it can lead you into a world of over diagnosis and anxiety. Just because your child has a birthmark doesn’t mean they’ll have any of the symptoms attributed to them.

Below I have a  brief description of some of the more common types of birthmarks and their syndrome possibilities. Please remember though that I’m just a parent who had a child with a birthmark and did some research. These may not be perfectly accurate descriptions and should only be used as guidelines. You should check with your Doctor to find out more information.

Stork Bites, Angles Kisses or Salmon patches are flat pink areas that are normally found between the eyes on the forehead in a “V” formation, or the nape of the neck.  There can also be small patches around the nose or mouth.  The majority of these tend to disappear by the time the child in one with the exception of the marks on the nape of the neck they tend to remain. Salmon patches are more noticeable when a baby is crying or when he or she is hot or cold.

Strawberry Hemangioma actually is raised and protrudes from the skin, looking similar in colour and texture to a strawberry.  Most strawberry birthmarks disappear on their own by the time the child reaches five. On some occasions the child will be approaching their teens before they notice it is disappearing. Generally they don’t need to be worried about, unless they are located in an area that interferes with normal everyday function like seeing, or eating and breathing.

Deep Hemangiomas or Cavernous Hemagioma are raised birthmarks that can range in color from, pale, skin colored, red to blue. They tend to be round lumps that may not disappear on their own.

Port wine Stain or PWS actually looks like some wine has been spilled upon the skin leaving a stain in a dark pink, red or purple.  The birthmark is a flat patch most commonly found on the face or limbs and rarely crosses the midline.  These tend not to fade on their own, but treatment is available for those who are looking.  Facial PWS that cover the eye and forehead need to be checked for Sturge Webber Syndrome (SWS), and PWS on the limbs should to be checked for Klippel-Trenaunay syndrome.

Café-au-lait spots are flat brownish birthmarks that tend to develop in infancy, and are generally located on the legs, torso or buttocks. A couple of these birthmarks is not a sign of a health problem, however, six or more spots that are larger than 0.25 in. (6.4 mm) or ones that occur along with freckles in the armpit can suggest neurofibromatosis.

Mongolian spots tend to occur in children of Asian decent and are smooth, brown or bluish gray birthmarks that tend to be found across the lower back and buttock region. A child may have one or several Mongolian spots that tend to disappear without treatment by age 3 or 4.

A PWS on the limbs can be attributed to Klippel-Trenaunay syndrome, which can result in asymmetrical arms or legs due to excessive growth of bone and soft tissue (hypertrophy) and typically affects only one side of the body.  The overgrowth may not be present at birth and may only be noticed after a few months or years. A CAT scan, an MRI or color Doppler can help determine the scope of the syndrome and how best to manage it.

A facial portwine stain over the eye and on the forehead can be a sign of sturge webber syndrome.  Which can lead to glaucoma and or seizures. A simple MRI with contrast can rule out SWS. A glaucoma test will probably be done periodically throughout your child’s life. Glaucoma can be treated with eye drops and if seizure activity is present your doctor will present you with the option of several medications to choose from with their pros and cons which you as an individual will have to decide which is best suited for your child. If you even choose to medicate. Remember that all seizures are not grand maul seizures, which the majority of us are familiar with. Some seizure activity is hard to detect and if you think your child is having seizure like activity an EEG can be done to help determine this.

Neurofibromatosis is a genetic condition that causes non-cancerous tumors to grow on nerves and produces abnormalities in the bones and skin. Most cases of this are mild and do not require treatment. Severe cases of neurofibromatosis are not curable but can be surgically treated to prevent discomfort and relieve symptoms.

Glaucoma is an eye disease that causes pressure within the eye and can damage the optic nerve and cause blindness. Most lose their sight because early symptoms go undetected and the damage can sometimes be irreversible. So constant monitoring is necessary for everyone.  When a PWS is present near the eye closer monitoring may be necessary.

Seizures are caused by abnormal electrical discharges in the brain. Depending on the area of the brain that is receiving these stimulations, a variety of different activity can be noticed, from unusual sensations, uncontrollable muscle spasms, to loss of consciousness.

Magnetic resonance imaging (MRI) is a noninvasive way to view detailed pictures of the inside of your body using a magnetic field and radio waves. Because you must be very still during these sessions sometimes young children are given an anesthetic.

Electroencephalograph or EEG is a noninvasive way to read brainwave patterns. It can allow doctors to follow split second changes in the brain under different circumstances. The brain has different patterns of current under different states such as asleep, awake or under anesthetic and can map the changes for a trained professional to read.

Computed Axial Tomography (CAT scan) is a noninvasive way of using computers to generate a three-dimensional image from two-dimensional x-ray pictures, one section at a time.

A color Doppler test uses ultrasound to determine how well the blood is flowing through major arteries and veins. It produces a picture of the vein, which then overlays colour to show direction and speed the blood is flowing.

 

“In order to be irreplaceable one must always be different.”  Coco Chanel

 

If you think your child has a birthmark that needs some extra attention, please remember that a lot of the syndromes are only recognizable through MRI’s or cat scans which can sometimes take quite awhile to get. There will be an ongoing process for quite sometime

to get your answers. Your questions will not be answered over night even though as a parent you want the answers now, so you can fix possible problems now. The anxiety can be overwhelming, but remember that everything takes time and nothing is going to get worse during the wait. Just sit back and enjoy your new baby and smother him or her with millions of hugs and kisses.

There are three different paths to take if your child is born with a birthmark that you think may cause social reactions that you’d rather your child not have to endure. You could choose to do nothing at all, and wait for your child to be old enough to make their own decision. You could use makeup as a camoflauge, or seek laser treatments for removal.  Everyone’s decision will be different because of all of the different factors that are involved with each individual mark and personal or religious beliefs.

For laser treatment, the United States is different from Canada in their care of treating a PWS.  Where the U.S. is quite aggressive when it comes to treating and likes to start as early as two weeks old when the skin is very young and thin, Canada generally likes to wait until the child is two years of age.  Of course these are just the general rule, and I’m sure will differ from province to province, or state to state as they would from Doctor to Doctor.  One thing you should know is that permenant removal is not garanteed.  Usually doctors will say that 80-90% fading will be noticed. Your doctor will have to determine how many sessions will probably be needed to get this fading and then yearly maitenance treatments will probably have to be done to maintain the effects.

IF you choose to try makeup, or have it on hand for your child is older and asks, there are many different brands available for anyone to use, that can be mixed to match any skin tone. These are some common types used in the birthmark community. Dermablend – Covermark – Coverblend – Microskin – JoeBlasco – CoverFX (which is now in shoppers drug mart)

Our son, Clae, was born with a facial Port Wine Stain.  And I think he was going to be fairly shy, because he was already very laid back and reserved. So we may have had some ongoing problems with building his self esteem. Of course I’m just trying to see into a future that will never come now. But, my closest friend, knew how worried I was when he was born, about how he’d be treated in school, and wrote him this poem that I was going to, and still plan on illustrating.  It’s a beautiful poem about everyone being different, revised slightly and read by her at his funeral.

 

I highly recommend signing on to www.birthmarks.com to learn more information about living with a birthmark.  The best way to get answers to all of your questions is to sign onto their email list.  It can be overwhelming getting 10-20 plus emails a day but everyone on the list is like family and will try to answer as many questions as possible, the best way to get those answers is to talk to other parents that are going through the same things, or other adults that are living with birthmarks now.  I wish you and your family all the best, and good luck with your research and any of the decisions you may encounter.