Modified from Pristine Lee, MD, Pediatric Dermatologist, Kaiser San Rafael
WHAT ARE HEMANGIOMAS?
Hemangiomas are collections of immature blood vessels in the skin. They are a common birthmark and are present in ~5% of newborns. They may not be visible at birth, but often develop in the first few weeks of life. Initially they may look like a reddish-blue skin marking before they grow and become more apparent.
Hemangiomas have a unique natural course: once they are present, they show rapid growth for 6-12 months (proliferative phase). They grow most rapidly from 3 – 8 weeks of age, but can continue to grow until 6-9 months, at which time they slow down their growth. By 12 months, they tend to stay stable with very little change for several months (plateau phase), before they slowly start to shrink (involution phase).
Though it is difficult to predict how one particular hemangioma is going to behave, it is important to remember this natural course, especially during the time of rapid growth. We understand that this is very worrisome to parents, and we would like to follow your child closely during those months and provide the needed support! The first signs noted when the hemangioma starts to resolve are a change of color from bright red/blue to grayish and no further increase in size. It may take months or years for the hemangioma to shrink, but the cosmetic result at the end is usually excellent without any treatment. As a rule of thumb, clinical experience has shown that by age 3 years, 30% of hemangiomas have completely shrunk; by age 5 years, 50% and by age 9 years, 90% will have shrunk. It is important to remember that when the hemangioma has fully shrunk on its own, it will not necessarily be "completely gone" as they can sometimes leave behind stretched skin or discoloration.
CONCERNS ABOUT HEMANGIOMAS
Since hemangiomas can occur anywhere on the body and come in all shapes and sizes, there are some situations when they may cause problems and may need treatment.
Location is an important factor. If a hemangioma is found near the eye, nose, mouth, ear or groin/buttocks, it may cause pressure and interfere with the normal function of important body parts. It may cause problems with vision, breathing, feeding and toileting.
Ulcerationcan occur during the rapid growth phase of a hemangioma. If this happens, it is often painful, will leave a scar and may get infected.
Bleedingof the hemangioma may happen, particularly if the area has been accidentally hit. If the hemangioma bleeds, hold firm pressure for 10-15 minutes.
If any of the situations mentioned above occur, we would like to hear about
There are different treatment optionsand combination of treatments available, which we would discuss with you given your child's unique situation
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