Dr Phil Kieran: My six-month-old has a strawberry mark on his face

Strawberry marks, or haemangiomas as they are called in medical speak, are small blood vessel collections on the skin. Picture: iStock

My son has a red mark beside his eye, which the doctors have told me is a strawberry mark. They say it won’t cause problems, but it seems to be getting bigger now that he is six months old. What can I do to help the mark to go away?

Strawberry marks, or haemangiomas as they are called in medical speak, are small blood vessel collections on the skin. 

They are fairly common — about one in 10 babies will be born with them and are more common in girls than boys.

There are two types of marks: superficial, which are bright red and can feel warmer than the surrounding skin, and deep, which can often look like a blue spot. These are caused when the blood vessels in the skin form nest-type structures instead of smooth tubes.

Haemangiomas are benign, so they don’t tend to cause problems or invade other tissues. They frequently do however get bigger for the first two years of life. This is likely why your son’s mark is growing.

In most cases, they will shrink between the ages of two and five and can be mostly gone by age eight.

Strawberry marks usually form on the face, and if they aren’t bothering the child you can just keep an eye on it. They can bleed a good bit if they get cut, so keep the baby’s nails trimmed. 

If they start to bleed, apply pressure for about five minutes, which will almost always stop it. Sometimes after they have been injured the skin can become dry and a little Vaseline or other moisturiser can help with this.

If strawberry marks appear in certain locations, we can be more concerned. Lesions near the eye can affect vision so they should be assessed regularly to ensure this isn’t happening.

Ones on the lip or neck can also cause difficulties with feeding or in some cases breathing so if it is in this area the doctors will likely want to do further testing (possibly MRI) to see the full extent of the lesion.

If the hemangioma continues to enlarge or is in a problematic location, you may be advised to consider medical treatment. In these cases, the medical team will look at the lesion and figure out whether it needs to be removed surgically or if it may respond to medication.

The medication prescribed is propranolol, which is taken daily for about 18 months. This drug is an old blood pressure medication used under the supervision of a paediatrician/paediatric dermatologist. 

It can have some side effects so it’s important to talk to the medical team about this in detail before deciding on treatment.

On the whole, strawberry marks are a very common condition and although it is enlarging at this time it is likely to stop enlarging and start to shrink by themselves.

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