A strawberry nevus, or hemangioma, is a red birthmark named for its color. This red tinge of skin comes from a collection of blood vessels close to the skin’s surface. These birthmarks most commonly occur in young children and infants.
Though it’s called a birthmark, a strawberry nevus does not always appear at birth. The mark can also appear when a child is several weeks old. They’re usually harmless and typically fade by the time a child reaches age 10. If it doesn’t fade, removal options are available to minimize the birthmark’s appearance.
While the hemangioma can be anywhere, the most common locations are the face, scalp, back, and chest. If you look closely at the area, you may see small blood vessels closely packed together.
Strawberry nevus of the skin can resemble a number of other types of red birthmarks. They are the most common skin growth in infants, affecting about 1 out of 10 children. A strawberry nevus can be superficial, deep, or combined. Superficial ones can be even with your child’s skin or raised and usually bright red. Deep hemangiomas, also known as cavernous, take up space in deeper tissue and often appear blue or purple. Combined hemangiomas are a mixture of both superficial and deep. A port-wine stain — a red or purple birthmark — differs from a strawberry nevus because port-wine stains typically occur on the face and are permanent.
A strawberry nevus will appear when extra blood vessels cluster together. The cause of this is unknown. According to Cincinnati Children’s Hospital, there are rare cases of several family members having hemangiomas in which genetics is assumed to play a role. Research is ongoing as to the exact cause of these skin lesions.
A strawberry nevus is rarely harmful. Some can leave behind a gray or white scar as they fade, making the area noticeably different from the surrounding skin.
In the severest cases, large hemangiomas can be life-threatening. A large nevus can cause problems and deformities of the skin and can affect breathing, vision, and hearing. Depending on their location, they can also complicate organ function. It’s important for a doctor to evaluate the size of the hemangioma and perform tests to determine if it’s harmful or not.
Doctors diagnose most strawberry marks by physical examination. In some cases, your child’s doctor may recommend testing to ensure that the mark does not go deeper into other tissues. If your doctor suspects that the mark is deep or close to a major organ, they may need to remove it. This typically requires care at a specialty medical center.
Tests to determine a hemangioma’s depth may include:
- biopsy, or tissue removal
- CT scan
- MRI scan
Because most strawberry nevus marks aren’t harmful and will fade with time, treatment is not necessarily recommended. In 2014, Hemangeol (propranolol hydrochloride) was the first oral medication approved by the FDA for treatment of hemangiomas in children, but it does have side effects.
If needed, treatments for a strawberry nevus include:
- topical, oral, or injected medications
- laser treatments
These procedures are performed by a medical professional who has experience treating hemangiomas. Consult with your doctor to see if your child is a candidate for any of these treatments. Side effects of these procedures can include scarring and pain as the removed tissue heals.
In cases of large and deep hemangiomas, a surgeon may need to remove the entire nevus. This is important is cases where the hemangioma may injure other tissues or organs.
Most strawberry nevus marks are harmless and will fade over time. However, in rare cases, they can be harmful. Talk to your child’s doctor to ensure any strawberry nevus marks are properly diagnosed and treated, if necessary.