What is a Strawberry Nevus?
A strawberry nevus is the common name for a 'hemangioma', a skin growth that presents in infants. They are not cancers and do not spread, but can cause problems if they grow near vital structures such as the eye.
What does a Strawberry Nevus look like?
They are skin growths that usually start to show in the first few weeks of life as a red spot. They then grow quickly, up to about 1 year old and can vary in size from just a few millimetres across to a few centimetres or more. At this stage the nevus looks swollen and bright red - hence the name 'strawberry nevus'.
Growth then stops for about a year, followed by slow disappearance of the strawberry nevus. During this last phase the color gradually changes from red to blue-grey.
Occasionally they may be confused with vascular malformations which can appear similar.
How common is a Strawberry Nevus?
They are very common, being present in up to 1 in 10 infants, increasing to 23% in pre-term infants. Most of these children will have only one strawberry nevus, but 20% will have two or more.
Can a Strawberry Nevus cause problems?
Not in general. They are not cancerous, and usually grow and then disappear without problems.
Ulceration and bleeding may occur during the nevus growth cycle - bleeding usually stops with pressure applied for a few minutes, and ulceration usually does not cause too many problems.
Depending on location, a strawberry nevus can occasionally cause serious complications such as airway blockage if growing inside the throat, hearing loss if growing in the ear or vision loss if growing over or into the eye. Very rarely, the strawberry nevus can cause heart failure or bleeding disorders (the platelet count may drop - platelets are cells in the blood). Whilst serious complications are rare, it is worth having all birth marks checked.
Will a Strawberry Nevus always disappear?
It is said that 50% have disappeared by 5 years old, and 90% have disappeared by the age of 9. Even if the nevus has disappeared, though, it may leave behind an area of loose skin which looks roughened and uneven. There may also be an area of discoloration looking like a small spot or bruise.
Some rarer types of strawberry nevus are present fully-grown at birth. These may then go down one of two paths - some will quickly collapse and disappear, but others will persist throughout life.
What is the treatment for a Strawberry Nevus?
Do nothing - as most strawberry nevi will disappear in the first few years of life, treatment is often not needed. If the growth is near an organ such as the eye then it should be carefully monitored to check for any problems.
Steroids - whilst the nevus is growing steroids can be injected into it, or taken by mouth. As steroids can have side effects, this is reserved for the cases where either the nevus is growing very large, or causing problems such as nose/eye/mouth obstruction, excess bleeding or cosmetic problems. Steroids are of no use once the strawberry nevus has stopped growing.
Surgery - again this is reserved for problematic nevi or those that are resistant to other forms of treatment. Surgery can also be used to remove any excess skin that is left after resolution of the nevus, although a scar will be left in place of the loose skin.
Laser - Laser has a limited role in strawberry nevus treatment, due to the thickness of the growths. Laser does, however, have a strong role in helping to manage bleeding and to lighten any residual discoloration left after the nevus has resolved.
- Other treatment - radiotherapy, interferon alpha-2a, and vincristine are all forms of treatment that may be considered if the above treatments are inappropriate or do not work. Propranolol, a medicine usually used to treat heart conditions, is also showing promise as a possible future treatment option for strawberry nevi.
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You may also be interested to read our article on vascular malformations
Any procedure involving skin incision can also result in unfavourable scarring, wound infection, or bleeding. This list of risks is not exhaustive, and you should discuss possible complications with your specialist. Whilst these risks will seem very worrysome, and indeed can be serious, it should also be borne in mind that many people have no postoperative problems whatsoever.
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