Hemangioma - Patients ask, Dr. Ringpfeil answers
Please feel free to use the blog below to share information about Hemangioma or to ask Dr. Franziska Ringpfeil a question that might be of interest to others.
Philadelphia and Mainline Center of Dermatology and Cosmetic Surgery
Hemangiomas
Hemangiomas are benign tumors that result from an overgrowth of blood vessels. They are categorized by the level of skin in which they reside. The types are superficial, mixed, and deep. Only about 1% to 3% of individuals have hemangiomas at birth. Most develop rapidly, beginning at 1 to 2 months of age, and continue growing until 6 to 9 months. After the rapid growth phase, the hemangiomas will spontaneously regress. Approximately 50% of hemangiomas will resolve by the time the child is 5 years old and 90% will resolve by age 9.
Diagnosis
The diagnosis is made clinically by the characteristic appearance of these vascular lesions. For example, superficial hemangiomas, also called strawberry hemangiomas, are bright red, whereas deep hemangiomas have a bluish hue.
Management
The majority of hemangiomas do not require treatment. The lesions can be measured and photographed. Monitoring for erosion is recommended. Hemangiomas located in areas that interfere with vision, feeding, or breathing may require treatment.
Treatment
Most hemangiomas will not require treatment because they are benign and will resolve without treatment. However, when treatment is required due to the critical location of the lesion options include surgery which is not often favored due to the resulting cosmetic defect, injections of corticosteroid, oral steroids, laser treatment, oral propranolol, or interferon.
Coping
Hemangiomas are painless lesions so specific coping strategies are not necessary for the young patient affected. Parents, however, often need reassurance by being educated about the benign and self-resolving nature of the lesions.
Parents need to understand that there will be a period of rapid growth and that it can take years for the hemangioma to fully resolve. Parents also need to understand that unnecessary aggressive treatment can put their child at risk for side effects and result in permanent cosmetic defects.
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I have what I think is a small cherry hemangioma on my nose near my eye. I do not like the appearance and want it removed. How would it be removed, what are the risks, how much would it be, and is there any chance of insurance coverage?
Cherry angiomas can be removed without a scar by a laser that targets the tiny vessels that make the angioma bright red. Treatment is painless and your eyes are protected with appropriate goggles. The angioma will turn purple with the treatment and this fades after 7 days. You will not see the angioma latest by 3 weeks after the procedure. Spots in skin level will require one treatment, and those that are elevated require 2-4 four weeks apart. Yu are expected to keep the laser treated the spot protected from the sun with a broad-spectrum sunscreen with SPF 50. Cost pre treatment of one angioma is currently $105. Treatment cannot be submitted to insurance.
I have a faded strawberry hemangioma scar on my forehead. It’s oval shaped and it’s indented into my skin.
Lax atrophic skin from a strawberry hemangioma can often be tightened by a series of laser treatments. Volume loss can be corrected by periodic placement of filler or by fat transfer if skin tightening is not visually reducing the indentation. I recommend a triaging consultation with one of our aestheticians so that we can best coordinate your care.