What are Birthmarks?
Almost everyone has a birthmark. In most instances, birthmarks are small, and often located in inconspicuous areas covered by clothing. Many people consider these innocuous birthmarks a sign of their own uniqueness. However, some birthmarks are clearly disfiguring, especially those that appear on the face and neck. These birthmarks can be a source of great psychological and social pain.
There are two basic types of birthmarks. Red or vascular birthmarks are caused by an irregularity in the blood vessels and are the most common type of birthmarks. Pigmented birthmarks, known as nevus (singular) or nevi (plural), are brown in color and may be very large. Many birthmarks fade before children reach school age, but more commonly, they remain if untreated.
Treatment options for birthmarks have traditionally included cryosurgery (freezing off the birthmark), traditional surgery, ablative laser surgery, and the use of steroid medications. These conventional treatments can be effective, but are painful. They frequently damage healthy skin resulting in scarring, and they require lengthy recovery times.
However, IPL™ provides new options for many patients with disfiguring birthmarks. IPL treatments are non-invasive. A series of treatments can provide a long-lasting solution for those suffering from unsightly birthmarks.
What are Birthmarks?
Birthmarks are individually unique areas of raised or flat discolored skin. Most birthmarks are visible on a baby's skin at birth; others may not show up for several days or weeks. Contrary to a popularmyth, they are not related to any trauma or stress experienced by mothers during pregnancy.
Most birthmarks are harmless; many fade on their own in the first few years of life. But some vascular birthmarks (caused by an abnormal cluster of blood vessels that grow during fetal development) can grow larger and more pronounced over time. According to the Vascular Birthmarks Foundation (www.birthmark.org), approximately 40,000 U.S. children born each year have birthmarks that require specialized medical attention.
Red and purple birthmarks appear in a variety of sizes and are the result of enlarged small blood vessels (capillaries) just beneath the surface of the skin. Vascular birthmarks do not fade away.
Hemangiomas are raised or bulging lesions that consist of dilated vessels that appear within one month of birth. Approximately 10% of all babies are born with hemangiomas. Although some regress during the first few years, 10% of hemangiomas grow in size by age 12.
Strawberry hemangiomas get their name from their bright red coloration and raised texture. This type of hemangioma may appear anywhere on the body, but is most common on the face, scalp, back, or chest. Strawberry hemangiomas consist of small, closely packed blood vessels. They may develop within several weeks following birth. They usually grow rapidly, remain a fixed size for a while, and then subside. 95% of strawberry hemangiomas disappear by the time the child is 10 years old, although there may be some slight discoloration or puckering of the skin that fails to regress.
In adults the most common hemangiomas are cherry angiomas, which appear as smooth, red projections.
Hemangiomas of many descriptions can be treated successfully using a Lumenis IPL™ device. After several, rapid treatments, the hemangiomas usually reduce in size, or are totally eliminated.
Port Wine Stains
Similar in appearance to other birthmarks, port wine stains show up as red or purple blotches on the skin, and do not fade away. The most familiar example of a port wine stain probably belongs to former Soviet leader Mikhail Gorbachov, who has one on his forehead. These birthmarks are caused by a web of dilated capillaries within the skin structure. Treatment involves closing up these capillaries, which are not necessary for blood circulation. The discoloration is resolved as blood no longer flows through the area.
About three out of every 1,000 babies are born with a port wine stain, which may grow progressively darker and thicker over time, changing the texture of the skin and becoming more difficult to treat. Port wine stains on the forehead, eyelids or both sides of the face are sometimes associated with other developmental abnormalities such as glaucoma, which, when left untreated, can cause blindness. Please consult your physician for more information and an examination.
Port wine stains were the first skin condition to be treated successfully with lasers and light technology. These treatments proved light's ability to treat blood vessels and blood without harming the surrounding skin structures.
Treatment of port wine stains requires a series of IPL procedures over several weeks. Through this gradual, cumulative process, the IPL can produce excellent results.
These faint, mild red marks are the most common type of vascular birthmarks, appearing on 30% to 50% of newborns. They are often called "angel's kisses," when they are located on the forehead or eyelids, where they tend to disappear by the age of two. When they're found on the back of the neck, they're called "stork bites" or "salmon patches," and usually last into adulthood. Macular stains may also occur on the tip of the nose, upper lip or any other body location.
Compared to red vascular birthmarks, pigmented lesions and nevi (moles) can be more difficult to treat. Lasers and IPL can often help in the fading process, but a complete resolution is difficult to achieve.
Cafe Au Lait Birthmarks
These light tan spots are common birthmarks that are similar in color to coffee with milk. About 20% of children are born with these discolorations, which usually shrink as the child grows.
These are small clusters of pigmented skin cells. Nearly everyone has moles, which usually appear after birth. Congenital nevi (moles present at birth) have an increased risk of becoming skin cancer. This is especially true if the mole covers an area of the body larger than a fist. All congenital moles should be examined by an appropriately trained health care provider.
Also called mongolian blue spots, they usually appear as bluish or bruised skin. They are often found on the lower back or buttocks and are more commonly seen in darker-skinned individuals. This birthmark may persist for months or years, but rarely becomes cancerous or develop other symptoms.
Many of the more conventional treatments to remove or diminish the appearance of birthmarks involve long and sometimes painful processes. The use of corticosteroid medications carries a number of risks. Cryosurgery (freezing off the birthmark) has limited applicability. Surgery and treatment with ablative lasers can cause scarring and harm nearby healthy skin. Fortunately, new laser and IPL™-based therapies are allowing physicians to successfully treat many types of unsightly birthmarks and pigmentation simply and non-invasively. It's important that prospective patients consult with a physician to determine the most appropriate treatment.
Intense Pulsed Light (IPL) for Vascular Birthmarks
A unique, non-invasive treatment strategy has revolutionized the treatment of the widest range of vascular skin lesions. Lumenis™ systems combining pulsed laser light and a broad band of Intense Pulsed Light offer the most effective and long-lasting treatment for port wine stains and hemangiomas. Lumenis systems use laser and IPL to selectively close off different size blood vessels at varying depths below the skin's surface, allowing the birthmarks to fade. Physicians are now able to treat complex birthmarks with pinpoint accuracy, eliminating the birthmark while sparing healthy tissue from injury. Discomfort and side effects are minimized, and virtually all patients return to their normal routines immediately afterwards.
What to Expect
Physicians determine a treatment plan for each patient depending on the size, location and other characteristics of the lesion. A large, facial birthmark can be treated in approximately 30 minutes, and a series of treatments is required for the maximum effect. Before treatment, a cold gel is usually applied to the area to be treated, and patients are given protective eye wear. During treatment, the smooth glass surface of the IPL handpiece is gently applied to the skin, delivering precise pulses of light to the area being treated. IPL treatments are considered pain-free, but an anesthetic cream can be used if the light pulses are uncomfortable. Some patients compare the sensation to a light pinch or the snap of a rubber band. Patients can return to their normal activities immediately after treatment.
What are birthmarks?
There are two basic types of birthmarks. Red or vascular birthmarks are most commonly seen, and are caused by an irregularity in the blood vessels. These include port wine stains and hemangiomas. Pigmented birthmarks, known as nevus (singular) or nevi (plural), are brown in color and are often less pronounced. Many birthmarks fade away before children reach school age, but they may remain and undergo changes over time.
What light-based treatments are most effective for vascular birthmarks?
Systems combining pulsed laser light and a broad band of Intense Pulsed Light (IPL) offer the most effective and long-lasting treatment for vascular birthmarks such as port wine stains and hemangiomas. Lumenis systems use laser and IPL to selectively close off different size blood vessels at varying depths below the skin's surface, thus causing the birthmark to fade. Physicians are able to treat complex birthmarks with pinpoint accuracy, eliminating the birthmark while sparing healthy tissue from damage.
Can children be treated with lasers and IPL?
Yes, in fact, most effective treatment programs for birthmarks begin in childhood. However, depending on the patient's age and the size and location of the birthmark, the child may have to be anesthetized to remain calm during treatment. Many laser specialists have experience in pediatrics and know how to manage such cases.
How long does a laser or IPL treatment take?
The length of a single treatment depends on the size and characteristics of the birthmark. Using IPL, treatment of a large facial birthmark may take about 30 minutes, with a series of treatments required for the maximum effect.
What is purpura?
Purpura is the temporary purple discoloration, the bruising effect that is sometimes left by the laser or IPL after a treatment of a port wine stain. Purpura usually subsides and disappears in two to four weeks.
What is a treatment with IPL like? Is it painful?
A pulse of Intense Pulsed Light energy may feel like a pinch or a rubber band snapped against the skin. A chilled gel applied to the skin and an optional, topical anesthetic prevent discomfort. Patients must wear protective eye wear to shield their eyes from the therapeutic flashes of light. The entire process is brief and non-invasive.
Are treatments with IPL safe? Are they approved by the government?
IPL systems are FDA-cleared to market for the treatment of a wide range of vascular and pigmented lesions. The system has an excellent safety profile.
Does insurance cover IPL treatment for birthmarks?
Coverage varies from carrier to carrier. Most insurance companies consider birthmarks as a cosmetic issue and do not offer reimbursement for treatment. Patients considering treatment should consult with their physicians and insurance carriers for more information. Some parent groups are lobbying for changes in insurance coverage. For more information, go to www.birthmark.org
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