The first time Kari Stewart noticed the little pink mark on her infant daughter Priya’s eyebrow, she figured Priya had scratched herself. But when the spot started growing and turned bright red a few weeks later, she worried it looked permanent, and took her concerns to the internet. “We discovered it was likely a strawberry hemangioma,” she says. “And the photos online did nothing to reassure us—they can grow bigger and cover a lot of skin. We didn’t know how big it was going to get.”
Superficial hemangioma (pronounced he-MAN-jee-oh-muh), sometimes called a strawberry, is a benign collection of blood vessels that form on the surface instead of underneath the skin. They’re one of the more common marks little ones develop. Most appear on the face, head and neck, and don’t require treatment. If you notice one, be sure to bring it up with your doctor, though. In 2018 the American Academy of Pediatrics issued new guidelines calling for a more active approach to the management of the birthmark. "Waiting until they cause problems misses a critical window of opportunity for treatments that can prevent significant complications such as permanent scarring, skin breakdown, or medical problems,” said Ilona Frieden, the paediatric dermatologist who spearheaded the new guidelines.
Though most appear by the time a child is a couple months old, paediatrician Umberto Cellupica says that hemangiomas go through a growth phase that typically lasts a few months. “Deeper cavernous hemangiomas look like purple or blue bulges under the skin. They can be very large, and cause problems with circulation or with organ function,” he says. But the majority of kids have superficial hemangiomas that appear during babyhood, and disappear by age five.
Some of the other marks that can show up on a baby’s skin are port wine stains and stork bites—both are caused when more blood than usual floods the capillaries under the skin. Port wine stains turn a reddish-purple and are often permanent; like hemangiomas, stork bites usually disappear, but can persist if they’re on the back of the neck.
Parents might worry about the cosmetic and emotional issues associated with a hemangioma. While comments from curious onlookers won’t bug your baby, adults can be more self-conscious. “I was stressed about it,” says Stewart. “I wished it had grown somewhere hidden, instead of the middle of Priya’s face.” But by 17 months, Priya’s strawberry started to fade.
A version of this article appeared in our August 2012 issue with the headline “On the mark,” p. 48.