Infantile Hemangioma

What is an infantile hemangioma?

An infantile hemangioma, commonly referred to as a hemangioma, is a type of birthmark composed of blood vessels. 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. 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, and also occur more commonly in premature infants.

What should I expect to happen to my hemangioma?

Infantile hemangiomas typically go through three characteristic phases: proliferation, plateau, and involution. The proliferative phase typically occurs in the first 6-12 months of life with the most rapid growth occurring in the first 3-4 months. The proliferative phase is characterized by rapid growth and sometimes by ulceration or breakdown in the surface of the skin. The plateau phase is characterized neither by growth or shrinkage, but rather by a relative stable period of development. Finally, the involution phase begins near the end of the first year of life and may continue for many years. Involution is characterized by color change from bright red to dull red-white color, decrease in firmness, and eventual flattening of the raised component. The final cosmetic result after involution is highly variable and depends on the location on the body, as well as the characteristics of the hemangioma.

What should I do if my child has a hemangioma?

Most infantile hemangiomas will develop without complication and eventually involute without the requirement for treatment. If a hemangioma is very large or affects the breathing system (airway or lungs) or another large organ system, it could be life-threatening. If a hemangioma has uncontrollable bleeding, this could also be life-threatening. Depending on where a hemangioma is located, it may cause physical problems, such as with moving a part of the body or difficulty with vision. Large, complicated, and/or life-threatening lesions should be evaluated by a multidisciplinary team of specialists that includes plastic surgeons, dermatologists, ophthalmologists, radiologists, and other specialists, depending on what organs are involved.

Treatment for hemangiomas

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 or ulceration, feeding or breathing difficulties, growth disturbances, or impairment of vision may require medical or surgical intervention.

Treatment may include the following:

  • Beta-blockers such as oral propranolol or topical timolol ophthalmic solution
  • Steroid medications
  • Embolization of the blood vessels (injection of material into the blood vessels to block the blood inflow)
  • Laser or surgical removal