What exactly is a “strawberry mark”?

By Betty Dolman (pharmacist West Block)

Infantile Hemangiomas (IH) are a type of birthmark commonly known as a “strawberry mark”. It is an overgrowth of blood vessels on or underneath the baby's skin. It occurs in about 5% of babies and usually appears from a few days to a few weeks after birth. We are not sure what causes hemangiomas, but they are more common in babies born prematurely and at low birth weight. 

There are two main types of IH; superficial and deep. Superficial hemangiomas grow on the skin surface and have a bumpy red appearance like a strawberry. Deep hemangiomas grow under the skin causing a bulge with a blue/purple tint. It is not uncommon to see a combination of the 2 types.

Infantile Hemangiomas typically start growing around 1 week of age. They can grow quickly and often reach a maximal size at about 4months of age. Most will start to shrink around 1 year of age and can be completely unnoticeable by age 6-7.

Occasionally IH can develop complications. These include functional impairment, painful ulceration and possibly permanent disfigurement. Functional impairment occurs when the hemangioma grows on a location such as an eye, affecting vision; the nasal cavity, affecting breathing; or the mouth, affecting eating and dental development. Ulceration is more common when the hemangioma is located in a high friction area and can result in infection, pain and scarring. Hemangiomas can also impede the proper growth of cartilage causing distortion of anatomical structures. 

IH is usually diagnosed based on appearance and the age when it appears. Ultrasounds and MRIs can be performed to see how deep a hemangioma runs and if it is affecting any vital organs. The majority of infantile hemangiomas are not treated because they usually resolve on their own. However, when a hemangioma is causing a problem, there are treatments available. This includes oral medications, injections, lasers and surgery. Always consult your pediatrician to find the best option for your child.