The National Craniofacial Association
P. O. Box 11082	* Chattanooga, TN 37401
800-	332-2373

Vascular Birthmarks

What is a Vascular Birthmark?

Very often, different doctors will use different terms to describe the same lesion. Advances are rapidly taking place in this field of study, so be sure you and your healthcare provider study the most recent materials. The correct treatment requires the correct diagnosis. Generally, Vascular Birthmarks are divided into two categories: Hemangiomas and Vascular Malformations.

What are Hemangiomas?

Hemangiomas are benign (non-cancerous) tumors that may or may not be apparent at birth, but always become visible within one to four weeks after birth. They usually occur on the head or neck, but they can occur anywhere, including the internal organs. The hemangioma will grow and change for the first 12 months of life and then "involute" or regress. The involution can last from three to 10 years.

What are Vascular Malformations?

Vascular Malformations are benign (non-cancerous) lesions that are present at birth, but which may not be visible for weeks or months after birth. Unlike hemangiomas, vascular malformations do not have a growth cycle and then regress -- they continue to slowly grow throughout life. There are five types:

• Port Wine Stains: Always present at birth and thought to be associated with a deficiency in the nerve supply to the blood vessels.
• Venous: Often confused with a hemangioma, these malformations will always grow, are soft to the touch, and the color disappears when compressed. Most commonly found on the jaw, cheek, tongue, and lips.
• Lymphatic: Formed when excess fluid accumulates within the lymphatic vessels.
• Arteriovenous: Caused when an abnormal amount of blood goes into the capillary beds and engorges the vessels.
• Mixed: A combination of any of the other four types.

Why did this happen?

Vascular Birthmarks are not the result of anything the mother did or did not do during pregnancy. The causes are currently being studied and there appears to be an inherited cause, but a proven genetic link has not been found.

Will my child need surgery?

Depending on the type of vascular birthmark, surgery may be recommended; however, the importance of obtaining a correct diagnosis is extremely important and often difficult. Before any surgery or treatment begins, be sure that your surgeon is extremely experienced in treating vascular birthmarks, that you have been given treatment options, that you ask how many such treatments the doctor has performed, that you ask to see before and after pictures of similar cases, and that you ask to contact one or two of these families. Treatment options can include:

• Steroid Treatment: Ask about medication that can be given for stomach upset which often accompanies this treatment.
• Laser surgery
• Surgical removal of the lesion
• Combinations of the above

New advances and procedures concerning Vascular Birthmarks are constantly being developed. Be an advocate for your child!

How do I get help for my child?
Your child should be treated by a qualified craniofacial medical team at a craniofacial center. Currently, FACES has information on sixty-four craniofacial teams located in 27 states, the District of Columbia, and Canada. This is by no means a comprehensive list of all the craniofacial teams. Please contact FACES for details.

Am I alone?
No! There are many families and organizations who will be glad to talk with you and help you with information and support. Don't forget books, videos, and websites. The listing below will get you started.

FACES: The National Craniofacial Association
P. O. Box 11082
Chattanooga, TN 37401
(800) 332-2373
email: faces@faces-cranio.org
We provide financial support for non-medical expenses to patients traveling to a craniofacial center for treatment. Eligibility is based on financial and medical need. Resources include newsletters, information about craniofacial conditions, and networking opportunities.

Hemangioma and Vascular Birthmarks Foundation
P. O. Box 106
Latham, NY 12110
(877) 823-5665
Email: hvbf@aol.com
Website:  http://www.birthmark.org
This network is dedicated to providing information to families, physicians, health care providers, and the insurance industry regarding the diagnosis and treatment of Vascular Birthmarks. They refer patients for treatment and diagnosis.

NOVA (National Organization of Vascular Anomalies)
P O Box 38216
Greensboro, NC 27438
Email:  khall@novanews.org 
Website: www.novanews.org
Excellent website, includes newsletter, message board, physicians list and other resources.

The following hospitals have dedicated vascular anomalies programs:

Arkansas Children's Hospital
Vascular Anomalies Center
1 Children's Way, Mail slot 668
Little Rock, Arkansas 72202-3591
501-364-7546
Clinic and Research Director, Gresham T. Richter M.D. F.A.C.S
Nursing or Team Coordinator, Jennifer Bowen, RN
bowenjd@archildrens.org

Vascular and Birthmarks Institute of New York
126 West 60th Street
New York, NY 10023
(212) 636-3977
Milton Waner, MD