Hemangiomas are simply a collection of extra blood vessels in the skin. They are the most common benign tumor occurring in infancy and may have different appearances, depending on the depth of the extra blood vessels.
Most hemangiomas are not present at birth but develop within the first few weeks to months of life. These hemangiomas of infancy typically occur as single lesions, and approximately 60 percent of them are found on the head. The less common hemangiomas that are fully grown at birth are called congenital hemangiomas.
The cause of hemangiomas is unknown. In very rare instances, they may run in families, but in general, they are not inherited. For a parent of a child with this birthmark, there is no increased risk of having another child with a hemangioma. Hemangiomas occur more often in girls than boys and are more commonly seen in premature infants.
The typical growth pattern of a hemangioma is as follows:
|Age of Child||Hemangiomas|
|Birth||often not present or noticeable|
|1-2 months||becomes noticeable|
|1-6 months||grows most rapidly|
|12-18 months||begins to shrink (involute)|
Hemangiomas usually involute (shrink) in time. Thirty percent of hemangiomas will resolve by 3 years of age, 50 percent by 5 years of age, and 80-90 percent by 9 years of age. Over half of hemangiomas heal with an excellent cosmetic result without treatment. Congenital hemangiomas either rapidly involute or do not shrink at all.
Types of hemangiomas
A strawberry hemangioma is an abnormal collection of blood vessels superficially in the skin characterized by a bright red color and well-defined border. A deep or cavernous hemangioma is a large collection of blood vessels beneath the skin surface characterized by a soft, bluish or skin-colored mass. Lastly, a combined hemangioma is a combination of a deep and superficial (strawberry) hemangioma.
Which hemangiomas need treatment?
Hemangiomas usually appear, grow and go away without problems. In most cases, we do not recommend treatment; however, some hemangiomas can cause significant problems. Scenarios that may be more complicated and require treatment include:
- Crusting or infection
- Rapid growth and deformity of the surrounding tissues
- Risk of scarring
- Involvement of a vital organ, like the eye or ear, or the windpipe
- Interference with vision, breathing, and swallowing
- Association with PHACES syndrome, an uncommon syndrome affecting the brain, heart, eyes, and skin
Hemangiomas in certain areas may have a higher risk of complications. These areas include the face (especially the nose and lips), body folds, and groin. Hemangiomas in certain locations, which affect function, or are complicated by infection or ulceration, may be treated with laser, medication or injections. If any worrisome signs appear, such as those listed above, please contact your physician.