Mr Juling Ong is a Paediatric Plastic Surgeon who specialises in the treatment of birthmarks and vascular malformations.
A birthmark is a skin irregularity that can be present at birth or appear shortly afterwards, typically within the first month. They can appear anywhere on the body or face and are caused by a malformation of pigment cells known as melanocytes, an abnormality of the blood vessels or an overgrowth of other types of tissue.
A correct diagnosis is essential as some birthmarks, such as haemangiomas, can naturally resolve themselves and treatment may not be necessary.
Vascular birthmarks are composed of abnormal blood vessels in the skin and there are many different types. The most common type of vascular birthmark, affecting up to 40 per cent of newborns is naevus simplex, also known as salmon patches. These flat, red marks are present from birth and commonly appear on the eyelids, nose, lip area or the neck. Most will fade over time and Mr Juling Ong will usually recommend no treatment.
Port wine stains or naevus flammeus are a darker pink or red patch on the skin that is usually present at birth. Port wine stains are generally not hereditary and are thought to be caused by the small capillary blood vessels failing to constrict.
Most do not result in other symptoms, although if they are present on the eyelids or cheek then they can cause increased pressure within the eye. As the child gets older, they can also become larger and darker and can bleed if scratched. Depending on their size and location, they can have a very negative impact on self-esteem which often prompts birthmarks treatment.
Strawberry naevi or infantile haemangiomas are raised vascular swellings that can look like a strawberry and are benign overgrowths of the blood vessels. They can appear anywhere on the face or body and typically appear within the first month after birth. Strawberry naevi do not usually cause any other symptoms but can be unsightly. They usually shrink after a few years and many do not require treatment.
If the haemangioma is bleeding, ulcerated, or causing impairment of function due to their position, they are best treated as early as possible. Although many haemangiomas will go away on their own, some will leave behind loose or baggy skin which looks different to the surrounding skin. Mr Juling Ong can advise on a range of treatment options to reduce the appearance of these haemangiomas.
Pigmented birthmarks include café-au-lait spots which are coffee-coloured birthmarks and are usually harmless but may be associated with more serious underlying conditions and if there are a number of them present then you should seek diagnosis. Mongolian blue spots are pigmented birthmarks that look like bruises. They are typically present from birth but usually resolve themselves after a few months or years without treatment.
Congenital melanocytic naevi are large black or brown moles that are present from birth. Although some fade over time, many will not and Mr Ong can advise on how these lesions are monitored and treated.
Frequently Asked Questions
How are birthmarks diagnosed?
Most birthmarks have a distinct appearance and Mr Juling Ong can usually provide a diagnosis based on this alone. Specific diagnostic tests may be needed in some cases, though, and these tests include ultrasound or MRI scans. A skin biopsy may also be ordered.
In many instances, the birthmark will need no further treatment as it should resolve itself over time, but some may need continual monitoring or treatment if they are very unsightly or are causing problems due to size or positioning.
What surgical and non-surgical options are there for removal of birthmarks?
Laser removal of a birthmark may be more appropriate than surgery. Surgical removal can be performed with a view to remove the birthmark entirely in one procedure, often described as direct closure. Alternatively, Mr Juling Ong may recommend staged removal of the birthmark in a number of smaller operations. Tissue expansion reconstruction is another option that Mr Ong may recommend.
Are there any risks to surgical birthmark removal?
Surgical removal of a birthmark will always result in a scar and great care will be taken to ensure optimal healing. Infection and bleeding are also risks of any type of surgical procedure.