Common Childhood Conditions
What Does a Hemangioma Look Like?
A hemangioma (pronounced hee-man-gee-no-ma) is a skin lesion. If it's red ("superficial"), then it's in the top skin layers. If it's blue ("deep"), then it's deeper in the skin. Often, there's a combination of these called "mixed".
Hemangiomas are usually not present at birth, although they may appear within a few months after birth. They often begin in an area that has appeared slightly dusky or differently colored than the surrounding tissue.
Hemangiomas in this area of discoloration can be isolated ("focal") or extensive ("segmental"). Most are isolated, and a few become extensive. Eighty percent are near the head and neck.
What Causes a Hemangioma and Who Gets Them?
Hemangiomas occur four times more often in girls than in boys and occur mostly in Caucasians.
Low-birth-weight babies (less than 2.2 pounds) have a 26 percent chance of developing a hemangioma.
Will Hemangiomas Change?
Hemangiomas can grow for up to 10 months and then usually begin a long, slow fading or regression known as "involution". This involution can last from 3 to 10 years.
While most hemangiomas eventually involute, the time to involution and the end result is not always acceptable, as it can leave a residual mass or scar.
Early intervention can reduce the need for corrective surgery after involution has occurred.
I Think I've Seen a Hemangioma on My Child. What Should I Do Now?
Someone who is familiar with vascular anomalies (blood vessel irregularities) should see your child.
This is particularly important because while some hemangiomas require no treatment, others can cause problems with vision, breathing, and feeding.
Infants who have what is referred to as hemangiomatosis (multiple hemangiomas) should be checked for internal lesions and other medical problems (such as hypothyroidism).
Hemangiomas that grow internally can be dangerous and are difficult to detect. When they are detected, the infant is often in need of immediate intervention.
Internal or visceral (organ) hemangiomas occur in the liver, intestines, airway and brain.
How Will Seattle Children's Diagnose a Hemangioma?
Hemangiomas are diagnosed by patient's history and physical exam. Often, this is all a doctor with a trained eye needs to do.
A classic description of a hemangioma is a premature baby girl who has red lesions appearing on the skin in the first month of life that grow rapidly in the first 6 months of life.
In more extensive hemangiomas involving multiple body sites, imaging may be done to confirm diagnosis.
The most helpful diagnostic aid is ultrasonography performed by a skilled ultrasonographer. MRI or CT scans can also sometimes be used to confirm diagnosis.
In some lesions that do not behave characteristically of the hemangioma, a tissue biopsy (cutting and examining a small piece of the tissue) may be necessary.
How Will Seattle Children's Treat a Hemangioma?
Hemangiomas are treated in several ways:
- Some small hemangiomas do not require any treatment.
- Larger hemangiomas or hemangiomas causing impaired function require treatment with steroids or other medicine.
- Sometimes hemangiomas that cause significant problems need to be cut out surgically to improve function. This is particularly important around the eyes and airway.
- Hemangiomas that persist and cause a cosmetic deformity often require surgical removal.
- Red hemangiomas can be treated with a laser.