by Carol DavisUPDATED: 20:49 EST, 20 February 2012
One in 20 Britons has a birthmark. Trisha Smith, 61, a retired care assistant from Stockton-on-Tees, had a non-invasive procedure to remove her birthmark.
One in 20 Britons has a birthmark (picture posed by model)
Five days after I was born, my mum noticed a blue ‘pimple’ on my bottom lip. Doctors said it was a birthmark, so she thought it would fade.
But as I grew, so did the birthmark.
Between the ages of five and 15, I had one or two operations a year on it.
Then it started to spread into my mouth and onto my tongue, causing my right cheek to bulge.
People would stare and I was very self-conscious.
My doctors said I had a vascular malformation, a birthmark caused by weak walls in blood vessels.
The blood wasn’t being pumped as it should, and the vessels were swelling, so blood pooled there.
They said operating on my tongue was too dangerous as I’d be at risk of excessive bleeding. I just had to get on with living. I met my husband, Geoff, at 15, and we had two wonderful children.
But by my 50s, the birthmark got so big I slurred when I spoke. I also developed sleep apnoea, where your airways are blocked in your sleep. I was sick of it all, so three years ago my GP referred me to plastic surgeon Tobian Muir.
He told me that instead of surgery, he could inject a drug usually used in cancer treatment into the birthmark to make the swollen veins seal up.
There’d be no scarring and very little pain — and it was likely the birthmark would never come back. it sounded amazing, and I hardly dared hope.
As there was a risk the treatment would make my tongue swell more, I had a temporary tracheostomy (an opening in the windpipe) so I could breathe if it did happen. Of course,it was frightening, but if it would help me get rid of the birthmark itwas worth it.
A month laterI had my first injection, under general anaesthetic. after the third, four months later, I could see the blueness and swelling receding, and instead there was normal skin for the first time. it was wonderful.
Two or three times a year, I’d have another injection, with a sedative instead of a general anaesthetic.
After a year, the tracheostomy was reversed because my tongue was becoming a normal size.
I had the last injection in January 2011. I’m so much more outgoing now. I wish this had been available before.
Tobian Muir is consultant plastic surgeon at South Tees Hospitals NHS Foundation Trust.
Vascular malformations are birthmarks caused when abnormal blood vessels form in the womb — the walls of the vessels weaken so they bulge.
They affect up to 5 per cent of us, for reasons doctors don’t fully understand, though we know they are partly genetic.
The bleomycin is injected into the centre of the abnormal veins
These abnormal vessels can swell with blood, and unlike many other birthmarks they usually persist for life. They can occur anywhere on the body, but are common on the head and neck.
Doctors can try injecting alcohol into these vascular malformations to destroy them, but alcohol is very toxic and can cause ulceration and scarring.
Patients may be offered surgery, but this leaves unsightly scarring and can mean profuse bleeding because the malformations are so rich in blood.
When they grow into or near the airways, surgery is too dangerous because blood could enter the lungs.
And in 20-40 per cent of cases, the birthmark grows back.
More recently, we’ve tried laser, which can be effective for superficial birthmarks, but not when deeper blood vessels are affected.
In the Seventies, a doctor in Japan tried injecting the cancer drug bleomycin into vascular malformation birthmarks.
This causes the abnormal blood vessels to seal and close. It’s very poorly transported by the body, so it doesn’t damage healthy cells.
Though this has been around for decades, it’s a treatment which is still too little known.
Around 93 per cent of patients respond to treatment, with four out of five showing significant improvement. The recurrence rate is extremely low, at just 1 per cent, and it’s scarless.
The procedure takes about half an hour. The patient is either sedated or has a light general anaesthetic because the injection is extremely painful, though there’s very little pain afterwards.
I inject the bleomycin into the centre of the abnormal veins, and it takes a few weeks for the blood vessels to seal up. The patient goes home a few hours later, without dressings or painkillers.
Patients return for around four more treatments, usually three to six weeks apart as the birthmark shrinks.
This simple treatment can be life-changing for patients whose breathing or limb movement has been affected by their birthmark.
Their confidence and social life improves, and best of all they say they feel normal again.
The procedure costs the NHS