Hemangioma

Hemangiomas are benign (noncancerous) growths, or birthmarks, that can appear reddish-purple in color anywhere on the body but are typically seen on the face, scalp, chest or back. They're caused by a buildup of blood vessels that didn’t develop properly during pregnancy. Hemangiomas seen in childhood are very common, occurring in approximately 3% of all infants in the U.S.

Symptoms of hemangiomas

Hemangiomas can be present at birth, but approximately 70% of them begin to appear within the first few weeks of life. Typically, a child only has one mark, but some children can have more – especially if they are part of a multiple birth.

Hemangiomas can also be identified by some of the following physical symptoms:

• Red or reddish-purple, raised patch visible on the skin
• Visible blood vessels within the growth
• Size between one-quarter and two inches in diameter
• Painless and doesn’t itch

Types of hemangiomas

Different types of hemangiomas are classified by how deep in the tissue they develop. There are four main hemangioma types:

Superficial infantile hemangiomas

Also known as capillary hemangiomas or “strawberry birthmarks,” these types of hemangiomas are superficial and appear on the surface of the skin. They initially appear as flat hemangiomas that are red in color but eventually grow bumpy and uneven on the skin.

Deep infantile hemangiomas

These types of hemangiomas grow deep under the skin’s surface, resulting in a smooth texture and bluish-purple appearance. Deep hemangiomas are also referred to as subcutaneous (under the skin). These tend to appear later and grow longer than superficial hemangiomas.

Mixed infantile hemangiomas

When a hemangioma has both a superficial and deep component present, it’s referred to as mixed. The growth pattern of these types of hemangiomas is between deep and superficial. They typically involve a longer period of monitoring by you and your child’s doctor.

Congenital hemangiomas

Congenital hemangiomas are less common than infantile hemangiomas. These vascular lesions, or vascular malformations, are caused by abnormally developed blood vessels. The tumor is benign but is present at birth. They’re typically light pink to bluish-purple in color with a round shape. Congenital hemangiomas can sometimes be seen on an ultrasound during pregnancy. These types of hemangiomas are fully grown at birth and can shrink, but do not completely go away.

Hemangiomas in babies can also develop within the organs inside the body (extracutaneous hemangiomas) such as within the lungs, liver, kidneys or brain.

What causes hemangiomas?

We don't know any hemangiomas causes. They sometimes run in families, but can also happen randomly.

Risk factors for hemangiomas

Hemangiomas are more common in White infants than any other race. The risk of developing an infantile hemangioma increases if a baby is born prematurely or has a low birth weight. Infants of multiple births, such as twins or triplets, also have an increased chance of developing infantile hemangiomas.

Do hemangiomas go away?

Most hemangiomas go away between the ages of 5-10. It’s common for a hemangioma to leave a child with the appearance of extra blood vessels on the skin or scar tissue.

During the first five months of your baby’s life, the hemangioma will grow rapidly during the proliferative or growth phase. The next phase is the rest phase where the hemangioma stops growing and begins to shrink. In most cases, the rest phase begins by your baby’s first birthday. Your baby’s doctor will monitor their hemangioma during routine checkups to ensure it’s developing normally.

Hemangioma complications

Hemangiomas can break down and cause ulcers, or wounds, that can be very painful. If an ulcer occurs, it can cause bleeding, scarring or an infection that needs to be treated to help it heal.

Other complications may arise depending on where your infant’s hemangioma develops including:

• Breathing complications if located on or near an airway
• Vision complications if located on or near the eyes
• Eating complications if located on or near the mouth
• Diapering complications if located on or near the diaper area
• Heart failure complications if large hemangiomas are present, especially in the liver

If the hemangioma bleeds, is painful or looks infected, contact your child’s doctor. You should seek medical care if you notice your child’s hemangioma causes any of the complications listed above.

Diagnosing hemangiomas

Infantile hemangiomas are typically diagnosed with a simple physical examination based on their appearance and when they began to develop. Deep infantile hemangiomas can sometimes be more difficult to diagnose in the beginning stages. Testing is typically not needed for diagnosis, but your child’s doctor may use ultrasound or MRI to get a closer look if necessary.

Treatment for hemangiomas

Most infantile hemangiomas eventually go away on their own and do not require treatment. If infantile hemangioma treatment is necessary, your child’s doctor will work with you and your child to determine the best treatment for them. If a hemangioma causes problems with vision or other complications, they may be treated with:

• Beta blocker medication: These medications, part of a class of drugs used to manage problems in the heart, are commonly used to treat infantile hemangioma. Some can be applied to the skin and others are taken orally to help shrink the hemangioma.
• Surgery: Typically, surgery isn’t needed, but your doctor may recommend it if other treatments haven’t worked. Most hemangioma surgeries are done as outpatient procedures, meaning your child can go home the same day.
• Laser treatment: Laser surgery may be used to remove small blood vessels and lighten the appearance of them, reducing discoloration. This treatment can also be used to treat sores on a hemangioma.