Hemangioma - Patients ask Dr. Ringpfeil answers
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Hemangiomas are benign tumors which result from overgrowth of blood vessels. They are categorized by the level of skin in which they reside. The types are superficial, mixed and deep. In only about 1% to 3% of individuals are hemangiomas present at birth. Most develop rapidly beginning at 1 to 2 months of age and continue growing until 6 to 9 months of age. 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.
The diagnosis is made clinically by the characteristic appearance of these vascular lesions. Superficial hemangiomas, also called strawberry hemangiomas, are bright red in color whereas deep hemangiomas have a bluish hue.
Most hemangiomas will require no treatment. Lesions may be measured and photographed. They should be monitored for erosion if they are large in size. Hemangiomas located in area which interfere with vision, feeding or breathing may require treatment.
Most hemangiomas will not require treatment because they are benign and will resolve without treatment. 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.
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.