Diseases & Conditions

Hemangioma

Birthmarks come in all shapes and sizes. A hemangioma — once known specifically as a strawberry hemangioma — is a birthmark that appears as a bright red patch or a nodule of extra blood vessels in the skin. It grows during the first year of life and then recedes over time. A hemangioma is usually benign and isn't associated with other medical conditions.

If your child has a hemangioma, know that most of the time the condition doesn't need any treatment. By age 10, a child who had a hemangioma in infancy usually has little visible trace of the growth.

A hemangioma, which is sometimes referred to as infantile hemangioma, may be present at birth or appear during the first several weeks of life. It starts out as a flat red mark anywhere on the body, most often the face, scalp or back of the neck.

During the first year of life, the red mark becomes a spongy mass that protrudes from the skin — often growing rapidly up to 2 or 3 inches (about 5 to 7.5 centimeters) in diameter. The hemangioma then stops growing and enters a rest phase. Eventually, it begins to slowly disappear.

Half of all hemangiomas resolve by age 5, and nearly all hemangiomas are resolved by age 10. Although the color of the birthmark also fades, faint — but permanent — discoloration of the skin or residual extra skin may remain.

When to see a doctor
Your child's doctor will monitor the hemangioma during routine checkups. Contact your child's doctor between visits if the hemangioma bleeds, forms a sore or bruise, becomes firm, appears infected, or grows rapidly.

A hemangioma consists of an abnormally dense group of extra blood vessels. It's not clear what causes the blood vessels to group together, although some research suggests a link between hemangiomas and certain proteins produced by the placenta during pregnancy.

A hemangioma is diagnosed based on appearance. Diagnostic tests aren't usually needed.

Occasionally, a hemangioma can break down and develop a sore. This can lead to pain, bleeding, scarring or infection. Depending on where the hemangioma is located, it may interfere with your child's vision, breathing, hearing or elimination, but this is rare.

The majority of hemangiomas never need any form of treatment. Treatment of hemangiomas is somewhat controversial. Some parents feel that hemangioma treatment is necessary because the marks can be disfiguring and may cause social or psychological problems. Doctors, however, may be hesitant to treat a hemangioma that isn't causing physical problems because hemangiomas usually fade gradually without treatment, and treatments have potential side effects. If the growth interferes with your child's vision or causes other problems, treatment options may include:

• Laser surgery. Lasers can stop the growth of a hemangioma. Sometimes lasers can be used to remove a hemangioma or treat sores on a hemangioma that won't heal. The risks are potentially serious, including pain, infection, bleeding, scarring and changes in skin color.
• Corticosteroid medications. Corticosteroids can be injected, given by mouth or applied to the skin. These medications are most effective when they're given during the growth phase. Sometimes long-term or repeated treatment is needed. The risks are potentially serious, including poor growth, high blood sugar, high blood pressure and clouding of the normally clear lens of the eye (cataract).

Because researchers want to find other treatments that are effective, with fewer side effects, research is ongoing. Some newer, though still experimental, treatments include beta blockers, interferon alfa and topical immune suppressants.

If you're considering treatment for your child's hemangioma, carefully discuss this with your child's doctor. Remember, most infantile hemangiomas disappear on their own during childhood.