Hemangiomas are an abnormal cluster of blood vessels that occur typically close to the surface of the skin in infants. It more commonly occurs around the face, the head and the neck, but it can occur anywhere on the body.
When babies are born with these, the hemangiomas are pretty prominent; some are more superficial than others. If a hemangioma is bright red and close to the surface of the skin, you might hear people refer to them as “cherry hemangiomas.”
Hemangiomas can be dramatic cosmetically and very bothersome to some families. The good news is, they will eventually go away. Unfortunately, a child has to live with them for several weeks to months, usually in the first one to three years of life. It is also distressing to parents because hemangiomas typically will grow faster than a baby grows for about the first six months of life. The legion will get larger and larger relative to the baby.
How they go away
Usually at around 6 months to one year of age, the lesion will start to shrink up and go away. If we leave them alone and let them disappear on their own, there is typically no cosmetic remnants and the skin will return to normal.
The only time we get concerned about hemangiomas is if they are obstructing an important function. For example, consider a hemangioma that’s in the corner of a child’s eye and blocks part of the visual field. If the eye doesn’t have stimulation or is able to see out of part of the visual field, the brain will redirect those nerves to have a different function. Even though the hemangioma may go away, that child may be functionally blind in part of their visual field.
If there is a hemangioma obstructing part of the nose or anywhere around the mouth or going down the front of the neck they can be potentially dangerous. We worry about those lesions because it can make it harder for the child to breathe. Hemangiomas can be a little bit like an iceberg, meaning we might only see the tip of it and it might actually go quite a bit deeper into the body.
When they are treated
If we have a hemangioma that is obstructing function or if we have one that’s so superficial it leads to cracking and bleeding, these are the lesions we would treat.
We used to have methods that weren’t great because they always left behind some pretty substantial cosmetic changes. Interestingly it was discovered that a certain class of beta blockers used to treat heart conditions in children also caused hemangiomas to dry up very quickly.
The use of this medication to treat hemangiomas requires the child to be hospitalized because it can cause changes to the child’s heart rate and blood pressure and could cause them to have low blood sugar.
The good news is most children do tolerate the medication well and the hemangiomas tend to resolve pretty quickly.
Hemangiomas are a common childhood condition that has a lot of good outcomes when treated properly.