Hemangiomas are the most common vascular birthmarks. Often referred to as infantile hemangioma, they appear within the first few weeks of child’s life and may grow for up to 12 months before undergoing a slow process of change and in many cases disappear.
Although hemangiomas can occur anywhere on the body, more than 60% are found on the head and neck. Usually, hemangioma will appear as a single mark (focal lesions); however, some patients may develop multiple hemangiomas (hemangiomatosis) or a hemangiomas spread over a large area of the face or body (segmental).
Types of Hemangiomas
- Superficial hemangiomas, or a "strawberry mark," will appear flat and bright red on the top layer of the skin
- Deep hemangiomas grow beneath the top skin layer, and may not be initially evident until later when they have grown to a noticeable size and protrude beneath the skin
- Compound or “mixed” hemangiomas involve both the top skin layer and the tissue below
Risk Factors for Hemangiomas
Hemangiomas most often occur in:
- Patients with light skin
- Associated with low birth weight or premature births
When to Consult a Birthmark Specialist
Wait and See Approach to Hemangiomas
Patients with a vascular birthmark should see a specialist at the 4-week well-baby check-up, or when it first appears. At this time, hemangiomas are just starting to grow and can be safely monitored. Patients will need monthly follow-ups for the first 4 to 6 months as this is the period when most of the growth occurs.
During these monthly evaluations, if the hemangioma remains stable (i.e., flat) or unchanged, the specialist will continue wait and see for any signs of changes. With close follow up, the vascular birthmark specialist is in a position to recognize any changes in size and/or thickness and begin treatment when necessary.
Early Intervention for Hemangiomas
While most hemangiomas remain small, each case is different and some hemangiomas may grow within critical areas that can be life threatening or cause functional impairment. Consult with a vascular birthmark specialist if the hemangioma is:
- Impacting vision, breathing, eating or hearing
- Growing rapidly
- Developing ulcerations
Patients with multiple hemangiomas (more than five) may be have a condition called hemangiomatosis and should also be evaluated by a birthmark specialist.
Cosmetic Treatments for Hemangiomas
Although in the past many doctors thought hemangiomas would simply "disappear" over time if left alone, it is now known that most children with hemangiomas on the face will require some form of treatment in order to achieve an acceptable cosmetic result. For many children requiring surgery for hemangioma, this can be done before the end of the first year of life, restoring the face and/or body to normal appearance, thus allowing the child to grow up and develop a normal sense of self awareness.