Infantile hemangiomas, commonly known as “strawberry marks,” are a frequent type of birthmark that can appear on infants. These marks often cause concern for new parents, leading to many questions. This article addresses whether these marks disappear on their own.
Characteristics of Strawberry Marks
Strawberry marks are vascular birthmarks. They are benign (non-cancerous) growths of endothelial cells. These marks are typically bright red and can be raised or flat. They commonly appear on the head and neck, but can develop anywhere on the body. Most become noticeable within the first few weeks to months of life, often by 2 to 3 weeks of age. They are common, affecting approximately 4% to 10% of infants, and are observed more frequently in premature babies, those with low birth weight, and in girls.
The Natural Fading Process
Most strawberry marks resolve naturally over time without medical intervention. This process typically involves three distinct phases. The first is the proliferation phase, characterized by rapid growth, usually within the first few months after appearance. Marks often reach 80% of their maximum size by around 3 months of age.
Following initial growth, the mark enters a plateau or stabilization phase, where its growth slows or stops. This phase can occur around 6 to 12 months of age. The final stage is the involution phase, during which the hemangioma shrinks and fades. During involution, the bright red color gradually changes to a duller red, gray, or whitish hue, and the lesion becomes softer and flatter.
The timeline for complete fading varies, but significant involution typically occurs by 3 to 4 years old. Many hemangiomas are largely gone by age 5 to 7, with some continuing to fade into adolescence, potentially up to 9 or 10 years of age. Even after fading, some residual skin changes might remain, such as slight discoloration, textural differences, or visible small blood vessels.
When Professional Guidance is Needed
While many strawberry marks resolve without complications, certain situations warrant medical evaluation or intervention. Marks located near critical areas, such as the eyes, nose, mouth, or airway, can interfere with function, potentially impacting vision, breathing, or feeding. Hemangiomas in the diaper area are also more prone to complications.
Medical attention is also advised if the mark is unusually large, growing exceptionally fast, or if an infant has multiple hemangiomas. Complications like ulceration, where the skin breaks down and forms a sore, are common and can cause pain, bleeding, or infection. Signs of a change in appearance, such as darkening color or crust development, can indicate potential ulceration.
A medical professional should also assess marks that do not show signs of fading by the expected age or exhibit atypical features. Various treatment options exist for hemangiomas that pose risks or do not resolve satisfactorily. These can include medications like oral or topical beta-blockers, laser therapy, or, in some cases, surgical removal. The decision for intervention is made in consultation with a healthcare provider, considering the mark’s size, location, and impact on the child’s health and development.