Hemangioma - Patients ask, Dr. Ringpfeil answers
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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.