May 19, 2003 -- Parents of children with large, red birthmarks known as hemangiomas may suffer more emotional and psychological stress over the condition than their child. A new study shows young children with the potentially disfiguring birthmarks are usually too young to be traumatized by their condition and benefit greatly from early treatment to reduce the appearance of the birthmark.
Hemangiomas are large, noncancerous, blood-filled, usually red birthmarks that affect about 10% of all infants by age 1. They are especially common in low-birth-weight, premature infants. Hemangiomas are caused by an abnormality in the blood vessels and occur most frequently on the face and neck. They usually do not pose a major threat to the child's health, although a few can be life threatening. But because the birthmarks are prominent and may be unsightly, researchers say the psychological stress of the condition on the child and his or her family deserves consideration.
Researchers say treatment for hemangiomas has greatly improved over the past decade, thanks to a better understanding of how these birthmarks grow and advances in laser technology. But only a small portion of hemangiomas require treatment, and most will resolve themselves before the child reaches school age.
In the study, researchers surveyed 39 children who were treated for hemangiomas and their parents about their attitudes toward the condition. The results appear in the May/June issue of The Archives of Facial Plastic Surgery.
The study found that families of children with hemangiomas experienced considerable fear and anxiety, but they generally felt that the child was not deeply affected by his or her condition.
"Most parents testified to the negative commentary or stares they received from others, leading them to seek professional advice from a specialty clinic," write researcher Edwin F. Williams, III, MD, of the Williams Center for Facial Plastic Surgery in Latham, N.Y., and colleagues. "Of the 39 parents, 10 professed that they were actually accused of child abuse because of their child's [birthmark]."
The parents acknowledged that the hemangioma had less of an emotional impact on the child and other family members, but they also felt their children were too young to appreciate their own condition.
In fact, the study also found that children didn't seem to be affected either positively or negatively by treatment to reduce the appearance of the birthmark for the same reasons of emotional immaturity.
But researchers found that parents of older children, ranging in age from 3 to 8 years, reported that treatment had a significant impact in improving their child's self-esteem and helping them feel less embarrassed about their condition.
"Our findings overwhelmingly indicate that the parents believe the emotional burden matches the physical nature of the disease," write the authors.
But although this information should help doctors counsel parents about hemangiomas, researchers say parental anxiety should never dictate the timing of treatment. Many types of hemangiomas may resolve themselves without treatment and should be given a chance to do so.
SOURCE: The Archives of Facial Plastic Surgery, May/June 2003.