What are hemangiomas?

A hemangioma is a red, bumpy growth that is like a strawberry in texture and appearance. Hemangiomas are caused by an abnormal build-up of blood vessels in the skin or organs. They are common and can be tiny or large. They often appear near the mouth and jaw, tip of the nose, or other facial areas.

Often mistakenly called "birthmarks," they actually appear at or after birth (unlike true birthmarks, which are fully formed before birth and don't grow further). Hemangiomas generally occur between birth and 18 months.

There are three main types of hemangiomas: superficial, deep, or mixed. Deep hemangiomas may appear more bluish than red at the surface.

How are they treated?

There are three stages in the lifecycle of a hemangioma: rapid growth, resting, and involutional (when it begins to disappear). Small, slow-growing growths may go away on their own and need no treatment at all.

Hemangioma at 8months 3 years later without treatment

However, larger hemangiomas that grow quickly, are cosmetically deforming, or affect vision, hearing, breathing, or other body functions should be treated early and aggressively. Examples include hemangiomas that block airways, grow on the eyelids, or cause facial disfigurement (even after being allowed to shrink away, hemangiomas can leave behind saggy, stretched skin).

Treatment options include:

• Laser is best for reducing the appearance of early-stage, superficial, or small hemangiomas. Lasers work by heating and shrinking the blood vessels within the growth. Scarring is minimal. Not an effective treatment for deep hemangiomas.
• Oral or injected steroids can help shrink deeper growths; this treatment may be combined with cryosurgery (liquid nitrogen that freezes off superficial growths) or laser. This is best if the treated area is small and not located on the face. Children and infants often tolerate steroids well and can be safely tapered off the medication
• Alfa-interferon is recommended for persistent hemangiomas that do not respond to steroids, infected lesions, or those that are dangerous (affecting breathing or other vital functions). Because of the alfa-interferon's association with spastic dysplegia (a disorder that causes problems with walking) in children, doctors use it with extreme caution.
• Surgical removal may be recommended for life-threatening or disfiguring hemangiomas that have not responded to any other treatment.