Infantile Hemangiomas

What Is an Infantile Hemangioma?

An infantile hemangioma (hee-man-jee-OH-muh) is a type of birthmark that happens when a tangled group of blood vessels grows in or under a baby's skin.

Infantile hemangiomas become visible in the first few days to weeks after a baby is born. Hemangiomas that are visible at birth are called congenital hemangiomas. They grow differently and are treated differently. Infantile hemangiomas are much more common than congenital hemangiomas.

The two main types of infantile hemangiomas are:

1. Superficial hemangiomas, or cutaneous ("in-the-skin") hemangiomas, grow on the skin surface. They're also called strawberry hemangiomas or strawberry marks because of their bumpy red appearance.
2. Deep hemangiomas grow under the skin, making it bulge, often with a blue or purple tint. Deep hemangiomas are also called subcutaneous ("under the skin") hemangiomas.

Hemangiomas also may develop in organs inside the body, such as the kidneys, lungs, liver, or brain, where they can't be seen.

What Are the Signs & Symptoms of an Infantile Hemangioma?

Most infantile hemangiomas grow larger for several months, then shrink slowly. They usually grow the fastest within the first 3 months. Shrinking may start in the later part of the first year and continue until a child is age 7 or older. Infantile hemangiomas often shrink (or involute) to the point that they're no longer noticeable.

Because hemangiomas grow and change, they're called tumors, but they're not a kind of cancer. Hemangiomas do not spread to other places in the body or to other people.

A child can have more than one hemangioma.

What Problems Can Happen?

A hemangioma may cause problems by:

• blocking vision or eye movements
• reducing air flow through the nose and mouth
• bleeding
• breaking down the skin surface (ulceration)
• having enough blood flowing through it to put a strain on the baby's heart
• affecting the child's appearance

Also, a large hemangioma on the face can be associated with vascular anomalies in the brain.

Infantile hemangiomas often grow on the head or neck, where they can't easily be concealed by clothing. Sometimes, the appearance of a hemangioma can make a child the target of teasing or bullying.

What Causes an Infantile Hemangioma?

The cause of infantile hemangiomas is unknown.

Who Gets Infantile Hemangiomas?

Hemangiomas are more common in babies born prematurely (before their due date), at a low birth weight, or as part of a multiple birth (twins, triplets, etc.).

Hemangiomas may run in families, but no genetic cause has been found.

How Are Infantile Hemangiomas Diagnosed?

An infantile hemangioma of the skin is usually recognized by how it looks and when it appears. Tests such as MRI or ultrasound scans can be done to see how far the hemangioma goes under the skin and whether it affects any internal organs.

How Are Infantile Hemangiomas Treated?

Most infantile hemangiomas are not treated because they usually go away on their own. The skin usually looks better if a hemangioma shrinks naturally rather than being treated.

When a hemangioma is causing a serious problem — such as bleeding or interfering with vision — treatment may be the best option.

These treatments might be used alone or in combination:

• medicine:
  • injected into the hemangioma
  • taken by mouth or circulated through a vein (IV)
• surgery to completely remove the hemangioma
• tying the vessel shut in a surgical procedure (ligation)
• embolization: blocking the vessels from the inside using a long, thin tube called a catheter that reaches the hemangioma through blood vessels
• surface laser for skin color changes

Looking Ahead

If treatment is needed, your child's doctors will discuss the options available and which is most likely to work well with minimum scarring or other side effects.

When an infantile hemangioma goes away on its own, it may leave behind a flap of stretched skin. Depending on the look and location of the loose skin, it might be removed with surgery.