The Great Strawberry Birthmark Debacle

{Warning: This post and the pictures are gross, make sure you don't mind pus!}

Zoe developed a strawberry birthmark which ulcerated a couple of days after she was born. We had no idea it would be so much trouble, and we had no idea that there would be next to no information (in NZ) or on the internet. So I'm writing about our experience with this type of ulcerated birthmark in the hopes that it puts some 'dumbed-down' straight forward REAL info out there for worried parents.

Strawberry Birthmark aka; Capillary Haemangioma, Capillary Naevus, Strawberry Haemangioma, Strawberry Naevus.

What is it? A red bubbly birthmark usually located on the head or neck area, more common in girls. It develops approx 3 days after birth, grows to 80% of its maximum size in the first 3 months and can keep growing for up to 18 months (most stop at 5 though) and can take as long as 3-10 years to go away completely. Up to 5-25% can become ulcerated, get infected and can leave a small scar. The majority of these types of birthmarks don't need treatment but marks that are located on the face, eyes/nose/mouth area could need laser treatment or even surgery!

This is the best website for information on these birthmarks: www.dermnetnz.org.

Around Christmas Zoe's mark doubled in size and ulcerated leaving an icky sore and scab. It is located on the back of her neck on the right, just in that annoying crease where her head meets her neck/shoulder area. Her clothes rubbed it raw and it got infected.

I took her to my GP who then sent us to Starship Childrens Hospital, where we spent a good chunk of 2 days waiting to see someone that could help. 6 different Doctors and Nurses saw Zoe and had never seen a birthmark ulcerate like hers before. It was SO frustrating. We were so stressed and so annoyed that no one could help. We were told we were going to have to wait a month to see a specialist because of the time of year, and to just wait to be contacted. All information was so vague, we had no idea what was going to happen - if anything.

Along came Christmas and we decided to see if the local Doctor in Katikati could help as we were down there for the holidays. She too hadn't seen this ulcerated type of mark before but prescribed antibiotics as she thought it looked infected. Because of the holidays the test results of the swab my GP took didn't get to us until later on which did indeed show a high level of infection.

The medicine had to be taken on an empty stomach, which is super hard with a baby! Zoe was on a snack (medicine), play, eat, play, sleep routine as we had to add the medicine to breast milk for her to take it, then wait 1 hour before she could actually feed. It was really hard work and threw her feed/play/sleep routine out the window (I've spent the last couple of weeks getting her back on track). She threw up her feeds a few times and it made her pretty grumpy.

We then had a nurse come each day and redress the wound (some quite poorly - it was a different nurse every time, we had to explain it every day - it was so exhausting) until Joel told them to no longer come over. We both knew we could do a better job of dressing it ourselves so we did (the sticky tape used just ripped Zoe's skin off and made things worse, even the alcohol based wipes that were needed to dissolve the tape just ate at her skin!). Joel worked out a dressing with the least amount of horrible sticky stuff and it worked a treat.

After a couple of weeks and clear slow healing of the wound, we bypassed the public health system and forked out some cash to see a private Pediatric Dermatologist (we did get a specialist appointment at Starship that same day but after waiting for an hour we bailed as we didn't want to miss both appointments). It was great! Finally someone who'd seen a mark like this before, who'd in fact seen plenty. FINALLY. He reassured us that laser treatment or surgery was not necessary, its bark is worse than its bite and that it will eventually go away. The best medicine is time and care. It was what we wanted to hear and we were really pleased. He gave us some solution to cleanse her bath water and some cream incase it looks to ulcerate again (fingers crossed it just disappears one day instead).

It was really very stressful for us as new parents. We were so worried that our little girl would need surgery, need to be put under and this giant thing cut out of her precious body. It seemed so huge at the time, but it doesn't bother her, it doesn't hurt her and we just put a light dressing on it to keep her clothes from rubbing it and it works wonderfully. As you can see from previous posts - she is a happy bubba so no problem there!

These photos were taken over time showing the growth, infection and healing. Yeah they are pretty gross and sore looking! eeeep!

17/12/09: first signs of it ulcerating and getting bumpy, 31/12/09: infected, 3/1/2010: starting to clear up and smooth out.

5/1/2010: small wound left, 7/1/2010: getting better and better, 12/1/2010 drying right up.

28/1/2010: This is how it is now, skin clear around the mark, still large though but skin all intact and cleared up. No scab or broken skin. You can see it better in the first pic in relation to her body and size.

I hope this (long) post has helped someone out there dealing with the same thing. If your child has experienced an ulcerated birthmark please write to me and let me know your story here.