Hemangioma (or infantile hemangioma) is a common, well-described vascular anomaly and is present in 1 out of 10 children. Technically, it is a benign vascular tumor of infancy that is usually not present at birth and appears a few days to weeks later. It typically begins as a small red patch or blemish and can rapidly grow to take on its classic appearance. Although most occur in the head and neck region, these tumors or vascular birthmarks can occur virtually anywhere on the body. The life cycle of these birthmarks is very predictable. After their initial presentation, hemangiomas go through a proliferative phase in the first year of life, where they can grow. Eventually, growth stops and the tumor enters a plateau phase. Hemangiomas will then go through a period of involution that may last anywhere between 5 to 10 years until they disappear.
Much confusion surrounds the term “hemangioma.” Many have ascribed this entity to other vascular malformations such as venous malformations which look and behave much differently than true hemangiomas. Some of the words used to describe these birthmarks are “strawberry mark” or “capillary hemangioma.”
Since most of these marks disappear over time, simple observation is usually all that is required. However, when hemangiomas occur on the face, they can pose a problem for vision, hearing or breathing, not to mention they can be unsightly or disfiguring. They can also ulcerate or bleed profusely. Treatment depends on the extent of the hemangioma and the parents’ wishes. For example, a small hemangioma that is present on the forehead or cheek may be excised. However, larger hemangiomas covering a portion of the face may not be amenable to surgery and may potentially benefit from medical therapy. Medications given by mouth include beta blockers (eg, propranolol or acebutalol) or steroids. Alternatively, problematic portions of large hemangiomas may respond well with one or more injections of steroids every 4 to 6 weeks. Parents frequently ask if lasers may be beneficial. Most hemangiomas are too thick to be treated with lasers. However, there are faint, superficial hemangiomas that may respond well. Also, if caught early, laser treatment may possibly control their growth. Consult Dr. Panossian for an evaluation of your child’s hemangioma for optimal treatment.
Dr. Panossian is an international expert on hemangiomas and other vascular anomalies and has treated hundreds of patients with these lesions. He belongs to the International Society for the Study of Vascular Anomalies, recognized as the preeminent organization for investigating and improving the understanding of all things related to vascular anomalies.