Common Childhood Conditions

Hemangiomas

What is a hemangioma? What does it look like?

Hemangioma

A hemangioma (pronounced hee-man-gee-o-ma) is a collection of extra blood vessels in the skin. Hemangiomas are usually on the head and neck, although they can appear anywhere on the body. They are one of the most common skin problems in children under age 1.

Hemangiomas are usually not present at birth. They often appear a few days to 2 months after birth. When they occur at this time, they are called "hemangiomas of infancy".

What causes a hemangioma and who gets them?

Doctors don’t know what causes hemangiomas.

They occur 4 times more often in girls than in boys. They mostly affect Caucasians. Low-birth-weight babies (less than 2.2 pounds) also have a higher chance of developing a hemangioma.

How do hemangiomas grow?

Hemangiomas keep growing for the first couple of months after they appear, but rarely for more than 8 months. After hemangiomas stop growing, they usually begin a long, slow fading process called "involution". This can last from 3 to 12 years. About 50% of hemangiomas fade completely by age 5. About 70% fade completely by age 7.

In rare cases, hemangiomas grow inside the body. These can be dangerous because they can cause problems with vision, breathing or feeding, depending on their location.

Why choose Seattle Children’s for hemangioma treatment?

Our Vascular Anomalies Program is one of only 2 on the West Coast and is among just a handful in the country. Families travel to see our experts because we have helped so many patients with vascular anomalies and use the latest treatments and techniques. Our doctors and surgeons have treated hundreds of children for hemangiomas and performed more than 30 surgeries each year. We have been able to reduce the number of noninvasive hemangioma procedures by 60% using effective, noninvasive therapies when possible.

Our vascular anomalies team includes otolaryngologists, dermatologists, plastic and general surgeons, interventional radiologists, dermatologists and nurse practitioners. These medical providers work together to develop a care plan that is tailored to your child’s needs. This helps us make sure that each patient gets the best possible treatment. We can schedule your child’s visit so they see all of the experts they need on the same day.

Our providers use research to find better treatments and improve quality of life for children with hemangiomas and other vascular anomalies. Seattle Children’s patients may have access to clinical trials for new therapies before they are widely available. Learn more.

What symptoms do hemangiomas cause?

A hemangioma is usually not painful unless an ulcer or a sore develops on it.

Hemangiomas near the eye can cause problems with a child’s vision. Hemangiomas near the mouth or on the face can make it harder to breathe or eat. Hemangiomas in the liver can cause hypothyroidism, which occurs when the thyroid gland doesn’t make enough thyroid hormone. This makes it important to see a doctor to evaluate your child.

How will Seattle Children's diagnose a hemangioma?

During your first visit to Seattle Children’s, the doctor will examine your child and ask about their symptoms. Your doctor may need to take an image of the inside of your child’s body to make a diagnosis. These imaging tests could include an ultrasound, MRI (magnetic resonance imaging) or a CT (computed tomography) scan.

Sometimes, the doctor will need to take a biopsy, where they cut a small piece of tissue from the skin and examine it. Our doctors are working on developing a new blood test to be able to diagnose these lesions.

How will Seattle Children’s treat a hemangioma?

Small hemangiomas do not require any treatment and will usually go away on their own. Larger hemangiomas, or ones that cause problems with breathing or vision, need to be treated. When treatment is necessary, options include the following:

  • Propranolol is the first line of treatment. Although rare, sometimes steroids or other medicines can be used. Research has shown that propranolol — a blood pressure medication — can shrink hemangiomas in some patients. Led by Dr. Jonathan Perkins, our doctors were among the first in the region to use propranolol to treat hemangiomas. Propranolol can reduce the need for surgery and make surgeries that are needed less extensive.

    Dr. Perkins’ team is developing a blood test that can predict whether propranolol will be effective in a child. This will help doctors quickly decide when a child needs surgery.

  • Laser treatment to remove hemangiomas, repair scarring or other skin problems.
  • Surgically removing hemangiomas that cause significant problems such as making it hard for a child to see or breathe.
  • Your child’s doctor will monitor the hemangioma to see how it changes over time. Perkins’ team developed a blood test that tells doctors if a hemangioma is shrinking even if it’s inside a patient and out of sight. This can save patients from imaging tests or biopsies.

Read more about how Dr. Perkins’ research is transforming hemangioma treatment

Contact Us

To learn more about hemangioma treatment at Seattle Children’s, call our Vascular Anomalies Program at 206-987-4606.