Hemangioma

Definition

A hemangioma is a type of birthmark. It develops shortly after birth, usually on the head or neck. It may be close to the surface of the skin or deeper below the skin.

For most, a hemangioma will grow quickly and then slowly disappear over time. It is often gone before puberty. If your child develops a birthmark that grows, talk to a doctor..

Causes

A hemangioma is a cluster of blood vessels that do not form normally. It is not known what cause hemangiomas. It is also unclear on what makes them grow, or disappear.

Risk Factors

Hemangiomas are more common in Caucasian baby girls. Other factors that may increase a baby's chance of a hemangioma include:

  • Premature birth
  • PHACE syndrome

Symptoms

Symptoms will depend on the location of the hemangioma:

  • A hemangioma that is close to the surface of the skin:
    • Appears as red strawberry-like or purple bump on the skin
    • May continue to grow and spread
  • A hemangioma that is deeper under the skin will appear as bluish swelling under the skin

Most hemangiomas have no further symptoms. However, some large hemangiomas may lead to:

  • Ulceration—deep sores in the skin
  • Scarring
  • Disfigurement
  • Problems with growth and function of structures nearby such as eyes or airway
  • Abnormalities of the blood vessels of the eye or brain (associated with some hemangiomas of the face)
  • Hemangiomas in other locations can be associated with heart, kidney, gastrointestinal, brain, or spinal abnormalities

Diagnosis

The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. Some hemangiomas are obvious with physical exam. If there is any question, your doctor may recommend testing. Tests may also be done to determine the size and effect on local organs.

Imaging tests can evaluate the hemangioma and surrounding structures. These may include:

Treatment

Most hemangiomas will resolve on their own. The mark will significantly fade by age five and nearly disappear by puberty. Your doctor may only recommend monitoring during the growth period.

If the hemangioma is causing problems your doctor may recommend one or more of the following treatments:

  • Dressings to help prevent infections in ulcerated areas of the skin and control oozing
  • Medication may include:
    • Acetaminophen for pain relief
    • Steroids, vincristine, or beta blockers to help shrink the hemangioma
    • Topical ointments to help with wound healing and pain relief
    • Antibiotics may speed healing with or without the presence of a bacterial infection
  • Surgery—particularly for hemangiomas that are causing pain, or problems with sight or breathing
  • Lasers—most effective on superficial hemangiomas

If ulcers have developed more aggressive treatment may be needed. It may require a combination of treatments above.

Prevention

There are no current guidelines to prevent hemangiomas.

Revisions

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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