A “strawberry mole” is a common birthmark, an infantile hemangioma. This benign growth is an excessive collection of immature blood vessels. They are among the most common vascular birthmarks, appearing in 4 to 5 percent of infants. They are non-cancerous and resolve on their own over time.
Appearance and Development
Infantile hemangiomas appear within the first few weeks of life, often as a faint mark or flat pink/red spot. These superficial lesions commonly present as bright red, raised, and bumpy areas, resembling the surface of a strawberry. While they can occur anywhere on the body, about 60 percent are found on the head and neck, with others appearing on the trunk or limbs.
The hemangioma then enters a rapid growth phase (proliferative phase), occurring during the first three to six months, sometimes up to 12 months. During this period, the lesion can grow quickly, often reaching 80 percent of maximum size by three months. Growth then stabilizes for several months in a plateau phase. The hemangioma then slowly fades and flattens (involution), a process that can take several years. Most complete involution by 5 years of age, though some may take up to 10 years.
Potential Complications
While many infantile hemangiomas resolve without issue, some locations or characteristics can lead to complications requiring intervention. The most common complication is ulceration, where the skin breaks down, forming a painful sore. Ulcerations can occur in rapidly growing lesions, particularly in areas like the diaper region, lips, or scalp, and may lead to bleeding or secondary infection.
Location can pose problems. Lesions near the eye may obstruct vision, affecting sight development. Hemangiomas on or around the nose can interfere with breathing, while those near the mouth or throat may make feeding difficult for an infant. Large hemangiomas, especially those involving internal organs like the liver, can cause systemic issues, such as heart failure.
Medical Evaluation and Treatment Options
A healthcare provider (pediatrician or dermatologist) should evaluate any suspicious spot to diagnose an infantile hemangioma. Assessment often involves a physical examination, though imaging (ultrasound or MRI) may be used for deeper or more complex lesions. For most hemangiomas, a “watchful waiting” approach is adopted, as they tend to shrink and disappear on their own.
When treatment is needed due to complications or high-risk locations, beta-blocker medications are primary. Oral propranolol, an approved medication for infants, is given twice daily for several months, effectively stopping growth and reducing size. For smaller, superficial lesions, topical beta-blocker gels (e.g., timolol) can be applied directly. Laser therapy (pulsed dye laser) is another option for ulcerations or residual redness/visible blood vessels after fading.