• Cardiology And Vascular Health
• Vascular Health

Hemangioma: More Than a Birthmark

If your child is born with a raised red or purple birthmark, or one appears in the first few months of life, he or she may have a hemangioma.

Hemangiomas are clusters of blood vessels that grow abnormally. They often appear on the face or neck but can form anywhere on the body. While most hemangiomas appear during the first six months of life, one-third are present at birth.

The good news is that many hemangiomas begin to disappear by age 5, and most go away on their own by the time a child is 10 years old.

Types of Hemangiomas 

Hemangiomas are considered noncancerous tumors. These marks are the most common type of benign skin growth. Hemangiomas tend to grow during the first six months, before they begin to shrink.

Hemangiomas vary by type:

• Capillary hemangiomas form in the top or outer layers of skin. These are often called “strawberry birthmarks.”
• Cavernous hemangiomas form in the deeper layers of skin or around the eye.
• Mixed hemangiomas include capillary and cavernous hemangiomas in one mass.

Who is At Risk for Hemangioma?

Hemangiomas appear more often in certain populations. They are:

• Three times more likely in girls
• More common in multiple births
• More common in premature and low-birthweight babies

The good news is that many hemangiomas begin to disappear by age 5, and most go away on their own by the time a child is 10 years old.

Symptoms, Complications & Diagnosis

Most hemangiomas do not cause symptoms, other than raised, red or reddish-purple bumps on the skin. In some cases, blood vessels can be seen just under the skin. You might notice a spot on your child’s face or neck that grows and changes in color.

Hemangiomas on or near an eye, however, can cause vision problems and affect development of the eye. These conditions include:

• Amblyopia, which causes “lazy eye,” or one eye to be weaker than the other. This condition can develop if the hemangioma is large.
• Glaucoma, which can occur if a hemangioma is located on the eye itself
• Vision loss and problems with the optic nerve, which can happen if a hemangioma is within the eye socket

Hemangiomas located in other parts of the body may also cause complications. If a hemangioma:

• Develops on an organ, it could affect how that organ functions
• Is near an airway, it may impact breathing 
• Is near nerves or joints, it may affect movement 
• Starts to bleed, it may be hard to stop the bleeding

In most cases, doctors diagnose a hemangioma with a physical exam. But if the mark is a cavernous hemangioma, or if it is located on or near the eye, your doctor may prescribe other tests.

Imaging tests used to check hemangiomas include:

• Computed tomography (CT) scan
• Magnetic resonance imaging (MRI) scan

Treatments Shrink and Reduce Appearance 

Most hemangiomas do not need treatment and go away on their own. Hemangiomas near the eye should be monitored to make sure they do not cause vision problems.   

Treatment needs depend on the size and location of the lesion and whether it is causing symptoms. Treatments options include:

• Steroids. These medicines are used to shrink the blood vessels in a hemangioma. Steroids can be taken by mouth, injected into the lesion or applied to the skin.
• Propanolol. This treatment works similar to steroids but has fewer side effects. Propranolol can be taken by mouth. If the hemangioma is small and thin, the medicine can be applied to the skin. Children who use propranolol should be monitored for any changes in heart rate and blood pressure when they start using this medicine.   
• Beta blockers. These medicines are sometimes prescribed to help reduce the size of a hemangioma.
• Laser treatments. Lasers can be used to stop hemangiomas from growing and to reduce redness of the skin.
• Surgery. If a hemangioma is small and well defined, it can be surgically removed. 

Surgery is also used to remove hemangiomas that affect the eyes, nerves and organs.

Living with Hemangiomas 

If your child is living with a hemangioma, he or she may feel self-conscious about how they look. Visible hemangiomas, especially those on the face, can cause emotional and social distress.

Be sure to talk with your doctor about support groups or counseling to boost your child’s self-confidence.

Even if a hemangioma goes away or shrinks, your child’s skin may look scarred, be discolored or look different. Ask your doctor about laser and other treatments that can help improve the skin’s appearance. 

Source: hemangioma, strawberry birthmark, capillary hemangioma, cavernous hemangioma, amblyopia, glaucoma, Premier Health