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Hemangioma Information

Infantile Hemangiomas

Hemangiomas are benign collections of extra blood vessels in the skin and are one of the most common skin problems of the first year of life. They appear most frequently during the first one to four weeks after birth and occur in about 5% of all children. Hemangiomas may look different depending upon how deep they are in the skin. More superficial hemangiomas tend to be bright red and elevated with an uneven surface. Deeper hemangiomas tend to be smooth on the surface, but blue in coloration. Many times, both red and blue components will be present (sometimes referred to as a mixed hemangioma). Not infrequently, the more superficial types of hemangiomas will begin as flat pink areas, but rapidly change into the elevated bright red growths.

Hemangiomas typically begin to enlarge in size beginning at age 2 weeks and usually growth most rapidly in the first several months of life.  They then begin to slowly resolve.  This resolution phase – called involution - occurs more slowly than the growth phase.  Most hemangiomas have begun to involute significantly between 1 and 3 years of age and most are significantly better by the time children reach Kindergarten.  Very large hemangiomas may continue to improve past this age, even up to age 10, but this is the exception.

Because all hemangiomas undergo involution, treatment is not needed in every case.  Many hemangiomas particularly those which do not involve the face do not require any treatment whatsoever, but many hemangiomas do need treatment.  These include those that may result in permanent disfigurement (involvement of the central face for example), severe ulceration, and problems with vital functioning, including eating, vision, hearing and breathing. Many effective treatment options are available.  These include oral medications (such as propranolol or cortisone), cortisone injected directly into the hemangioma, topical medications (such as clobetasol or timolol), laser therapy and surgery. The choice of which treatment is best depends on the age of child, location of hemangioma, size of the hemangioma and other factors.  In addition to whatever treatment –if any- is used, children with hemangiomas that cause problems must be followed closely especially when they are very young.  Thereafter, observation by your doctor can be at less frequent intervals.