Pediatric Hemangioma

Hemangiomas

A hemangioma is a type of birthmark. It is the most common benign (noncancerous) tumor of the skin. Hemangiomas may be present at birth (faint red mark) or may appear in the first months after birth.

A hemangioma is also known as a port wine stain, strawberry hemangioma and salmon patch. About 60 percent of hemangiomas occur in the head or neck area. Hemangiomas occur at least three times more often in females than in males. Most will continue to grow for the first six to 12 months of life before beginning to shrink.

Hemangiomas can be categorized into two types:

• Capillary hemangiomas (superficial): These form on the skin's top layers and appear bright red
• Cavernous hemangiomas (deep): These are embedded in the skin's deeper layers, often appearing blue or purple

Hemangiomas have three stages:

• Proliferation: Grows from a faint red mark to full size
• Resting: No change
• Involution : Mark slowly disappears

Hemangiomas usually develop by chance during fetal or early infant development, and their exact cause is still not fully understood. Hemangiomas are more common in females than in males, with girls being affected about three times more often. It's estimated that up to 5-12% of babies will develop a hemangioma in their first year of life.

Although most are benign and go away on their own, a small percentage may require treatment due to complications or rapid growth.

Most hemangiomas are not usually present at birth or are very faint red marks. Shortly after birth, however, they grow rapidly--often faster than the child's growth. Over time, they become smaller (involute) and lighter in color. The process of involution may take several years.

Vascular malformations are present at birth and enlarge proportionately with the growth of the child. They do not involute spontaneously and may become more apparent as the child grows.

Treatment for hemangiomas depends on their size, location and severity. Treatment is usually not recommended for small, noninvasive hemangiomas, since they will become smaller (involute) on their own. However, hemangiomas that cause bleeding problems, feeding or breathing difficulties, growth disturbances or impairment of vision may require medical or surgical intervention.

Treatment may include the following:

• Observation
• Medications
• Laser or surgical removal

Many hemangiomas, depending on their size and severity, will go away without treatment. These conditions can be life-threatening if they’re large or affect your child’s airway or another organ. A hemangioma can also be serious if it has uncontrollable bleeding.

Depending on where your child’s growth is located, it may cause physical problems. Your child may have trouble seeing or moving part of their body.

• Observation: Most hemangiomas will grow during the first 6 to 12 months of your child’s life, and then gradually shrink and fade over time (a process called involution). In many cases, they may resolve without the need for any treatment. However, it’s important to monitor them for any changes or complications.
• When to seek treatment: Some hemangiomas, especially those that are large, cause functional issues (like affecting vision, breathing or eating), or are located in sensitive areas (such as near the eyes or airway), may require medical intervention. In these cases, treatment should be managed by a pediatric specialist, such as a pediatric dermatologist who has experience in treating hemangiomas. They may recommend therapies such as medications (like propranolol), laser treatment, or in rare cases, surgery.
• Ongoing care: Regular follow-up visits with a healthcare provider are important to monitor the hemangioma’s progress. If the hemangioma causes significant cosmetic concerns, emotional distress or functional problems, your healthcare provider can guide you on the best treatment options.