Hemangiomas are benign vascular tumors that often appear in infancy and may cause visible skin discoloration, swelling, or, in severe cases, functional issues like vision loss or breathing problems. Led by Dr. Waner and Dr. O, Vascular Birthmark Institute offers expert care tailored to your child’s unique diagnosis and needs.
What Are Hemangiomas?
Hemangiomas are non-cancerous vascular tumors that develop in infancy and are the most common type of birthmark in babies. These growths result from an abnormal buildup of blood vessels and typically appear within the first few weeks of life. While many hemangiomas are small and harmless, some can grow rapidly, affect vital functions, or leave lasting cosmetic changes. At Vascular Birthmark Institute, we specialize in diagnosing and managing hemangiomas with precision, ensuring optimal outcomes for every patient.
Signs & Symptoms of Hemangiomas:
- Raised, red or bluish skin lesion that may resemble a strawberry
- Rapid growth during the first few months of life
- Swelling or firmness in the affected area
- Lesions that may ulcerate (up to 30% in segmental hemangiomas)
- Spontaneous bleeding from ulcerated areas (rare but possible)
- Visual obstruction or eye pressure leading to lazy eye (high risk if near the eye)
- Breathing difficulties due to airway involvement (urgent if present)
- Noisy breathing or stridor (possible sign of airway hemangioma)
- Pain or sensitivity in ulcerated areas (often severe and persistent)
- Delayed weight gain or failure to thrive (observed in some large or multiple hemangiomas)
- Signs of heart strain or failure in extensive lesions (especially with liver involvement)
- Telangiectasias (visible blood vessels) or scarring as they involute
- Thin, atrophic skin or hypertrophic (thick) scars after healing from ulceration
Types of Hemangiomas
Focal Hemangiomas
Focal hemangiomas are the most common type and typically appear as a single, localized tumor. They grow rapidly during the first weeks of life, with most of their growth completed by six to seven months of age. These lesions may be found on the skin surface, beneath the skin, or a combination of both. Superficial focal hemangiomas appear red, while deeper ones may have a bluish hue. Most focal hemangiomas are small and self-limiting, but some may cause complications such as ulceration or residual scarring.
Segmental Hemangiomas
Segmental hemangiomas cover broader regions of the body and often follow specific developmental segments, reflecting how the fetus develops in the womb. These hemangiomas grow more aggressively and for longer durations, sometimes up to two years. They are also likely to ulcerate and may lead to functional impairment or disfigurement. In approximately 30% of cases, they are associated with PHACES syndrome, a condition involving developmental anomalies of the brain, arteries, heart, eyes, and sternum. Due to their potential complexity, children with segmental hemangiomas should be thoroughly evaluated.
Treatments for Hemangiomas
At the Vascular Birthmark Institute, your child’s treatment plan begins with a thorough evaluation by our expert doctors. Using clinical examination, imaging, and when needed, consultations with specialists in cardiology, ophthalmology, or ENT, we assess the type, location, and severity of the hemangioma. From there, we design a personalized treatment strategy that balances early intervention with the potential for natural regression to ensure optimal long-term results.
Medical Therapy
The most common first-line treatment for problematic hemangiomas is oral propranolol, a beta-blocker medication. It works by narrowing blood vessels and reducing blood flow to the tumor, which slows or halts growth and encourages shrinkage. Propranolol is typically well-tolerated, but your child will be monitored for changes in heart rate, blood pressure, and blood sugar. In select cases, corticosteroids may be used to reduce inflammation and accelerate involution.
Laser Treatment
Laser therapy, such as pulsed dye laser (PDL), is often used for superficial hemangiomas, particularly those that ulcerate or leave behind visible vessels or discoloration. The laser targets the blood vessels in the lesion without harming the surrounding tissue. This reduces redness, seals off tiny blood vessels, and can alleviate pain from ulceration. It is a safe and effective option for improving skin appearance and managing residual changes after involution.
Surgical Treatment
In some cases, surgery is recommended, particularly for hemangiomas that ulcerate persistently, interfere with vital functions (such as breathing, vision, or feeding), or leave behind residual fibrofatty tissue after involution. Surgical excision removes the hemangioma or the leftover mass and can improve function and cosmetic appearance. We always aim to minimize scarring and achieve a result that supports your child’s development and self-esteem.
Monitoring and Follow-Up
Not all hemangiomas need active treatment. If your child’s hemangioma is small, not growing rapidly, and not located in a sensitive area, we may recommend monitoring. Regular follow-up visits help us track changes and intervene if needed. We also provide guidance on skin care and symptom management during involution to ensure your child’s comfort.
Schedule Your Consultation
Vascular Birthmark Institute is a world-renowned center dedicated to the expert diagnosis and treatment of hemangiomas and other vascular anomalies. Led by Dr. Waner and Dr. O, our team provides compassionate, individualized care that prioritizes function and appearance. Whether your child’s hemangioma requires monitoring or active intervention, we are here to guide you through every step. If you’re concerned about a vascular birthmark or seeking the best possible outcome, we encourage you to schedule a consultation today.
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