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HEALTH OUR expert Dr JOANNA LONGSTAFFE; Clinical director of the Independent General Practice answers your medical queries.

Q I am concerned about my 18 month old daughter's birthmark - none of my other children were born with them so I don't really know an awful lot about them. The mark itself is on her back and looks quite red and sore - it looks a similar shape and colour to a strawberry and is slightly raised. I have been debating whether to make an appointment with the doctor about it. Is this something I should be concerned about for health reasons? A Birthmarks can seem quite scary if you don't know a lot about them, especially in babies and young children but try not to worry too much as they are very common and most are completely harmless. Around one in three babies will be born with some form of birthmark, the cause is still unknown but doctors agree that there is no proven link between the marks and any food, activity or medication that is used during pregnancy so it could really happen to anyone.

There are a number of different types of birthmarks of varying size, shapes and colours - some will fade while others are permanent. In the main, birthmarks are categorised as non-vascular and vascular.

Non-vascular birthmarks such as pigmented birthmarks are very common. The marks are usually smooth, flat and cause discolouration of the skin - they are most often light brown in colour.

Vascular birthmarks, caused by broken blood vessels are also very common but these are usually red in colour. There are a variety of different types including the stork mark - a flat red mark usually found on the back of your baby's neck, eyelid or on the baby's forehead - and also port wine stains, which are red or purple in colour and usually flat.

From what you have described it sounds like your daughter may have an infantile haemangioma - which really does sound more serious than it actually is. These birthmarks are also called strawberry marks due to their shape and colour - they are usually slightly raised and can appear anywhere on the body.

Strawberry haemangioma birthmarks will commonly disappear by the time a child gets to around nine, although some slight discolouration may remain. The most important thing to remember about this type of birthmark is that they are mostly harmless especially if they are in an area such as the back - like your daughter's - where they don't really cause too much aesthetic concern either.

In some cases complicated or large birthmarks may require treatment, particularly if they are affecting the child's day-to-day life. Large birthmarks near the eye, nose or mouth may interfere with a child's vision, breathing or feeding. Some birthmarks in areas such as the lips or nappy area may cause ulcers and will therefore require treatment to alleviate any pain.

The exact treatment will depend on the individual case, in some cases oral medication such as cortisone can reduce the size of the birthmark. Other cases may require surgery, laser surgery or cryotherpay which is essentially freezing the area to remove it.

Some people who suffer from unsightly birthmarks may decide to remove them for cosmetic reasons; this is not recommended in young children however. If the child reaches an age where they decide to have a cosmetic procedure to remove the birthmark then there are many options available depending on the best cosmetic procedure for that individual case.

Usually birthmarks only cause a problem if they are in a difficult place such as very close to the eye as mentioned and doctors often recommend that birthmarks around the neck, chin and mouth should also be looked at to be on the safe side.

A GP should be consulted if any bleeding or ulcerating occurs but in general, the majority of birthmarks are harmless and as in the case of your daughter, likely to fade in time.
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Publication:South Wales Echo (Cardiff, Wales)
Date:May 9, 2012
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