Doctors’ Notes

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Hemangiomas

A hemangioma is a birthmark that most commonly presents after birth as a bright red, rubbery nodule. Otherwise known as a “strawberry patch,” hemangiomas are an extra collection of blood vessels in the skin. It’s not known what causes hemangiomas, but some experts believe a hereditary component may be involved.

Birthmarks, including hemangiomas, are common in infancy and most of them are harmless.

Hemangiomas usually appear within one to two weeks after birth. They most commonly appear on the face, scalp, or neck, but can occur in any region of the body. Girls are affected more often then boys. Caucasians and premature infants are also at an increased risk.

Hemangiomas can grow rapidly during the first six months of life. They go through a resting phase from about 6-12 months, then start to involute usually around 12 months of age. The involution stage can be a slow process. Half of all hemangiomas are resolved by age 5 and nearly all are resolved by age 10. Although the color of the birthmark typically fades, sometimes faint discoloration or excess skin may remain. Treatment of hemangiomas usually isn’t necessary, unless the nodule interferes with breathing or vision.

Complications that can occur from hemangiomas that would require further follow-up and treatment include:

  • Hemangiomas near the eye, eyelid, or mouth that may interfere with vision or breathing.
  • Ulceration (skin breakdown) of the hemangioma. This can be painful for the child and lead to poor feedings, irritability, and infection.
  • If an injury or cut occurs at the site of a hemangioma. The concentrated amount of blood vessels that make-up a hemangioma can cause it to bleed rapidly.
  • Multiple hemangiomas may warrant an ultrasound to check for internal hemangiomas.

Once again, hemangiomas typically do not require treatment. However, if any of these complications occur, treatment options include:

  • Oral systemic corticosteroids — to slow progression/growth of hemangiomas.
  • Surgical removal.
  • Laser therapy — if any discoloration remains after involution phase.
  • Propanolol — a blood pressure medication that inhibits growth of blood vessels and constricts existing blood vessels within the hemangioma). Timolol — another blood pressure medication– is used in a gel form and applied directly to the hemangioma. Both these medications cause hemangiomas to fade and shrink more rapidly.

Unfortunately, there is no way to prevent infants from getting hemangiomas. But rest assured that hemangiomas are common, usually do not require treatment, and most likely resolve on their own.

Katie LaMendola, a Family Nurse Practitioner, co-teaches our Puberty. Seriously? class.