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Most vascular birthmarks are diagnosed visually, meaning you go in and see the doctor, they take a look, and if they are vascular birthmark specialists, they know what it is. They can tell you exactly what it is. At that point, they can determine treatment. Most of these are going to be just looking at numbers. A hemangioma: if it’s a small one, it doesn’t need to be treated. If it’s slightly larger, it can be treated with propranolol, which is an oral blood pressure medication. If they’re smaller and flatter, you can treat them with Timolol, which is a topical blood pressure medication for the eye. Otherwise, they can be treated with a laser so they can shrink down. Classically, they were treated with steroids (which is an injection) and the larger ones are treated by excision and closure, meaning we cut them out and we close the area like they were never there. Other types of diagnosis needed: again, if you see a vascular birthmark specialist (or an ear, nose and throat specialist) and they do see that there’s a pattern of the vascular birthmark on the face that they were worried about, they will perform either imaging or endoscopy. They do that to make sure that there’s no growth down into the airway. The imaging they can do can look at the airway and it can look at the areas around the brain to make sure that the patient or the baby will not develop future problems with the fluid pressure around the brain. If it’s somebody who has arterial venous malformations, they would do the same kind of scanning around the body to make sure that there are no more or no further malformations in the liver or in other vital organs.
