Rapidly Involuting Congenital Hemangioma (RICH)

One type of congenital hemangioma that is present at birth is a RICH, or rapidly involuting congenital hemangioma. These vascular tumors grow in utero and do not continue to grow after birth. While they may look like infantile hemangioma, they do not continue to grow and spontaneously involute in a much quicker period. RICH are benign, but it is important to have an accurate diagnosis of these growths by a vascular physician as they can be misdiagnosed.

Most RICH occur on the head, usually on the scalp, forehead or ear area. They can also appear near the joint on a leg or arm. A RICH is usually oval or round shape, with a pink or bluish hue, raised above the skin. They are usually warm to the touch and are surrounded by paler skin around the edges. Size can vary, from small to encompassing an entire knee or other large joint.

Is Treatment Needed for RICHs?

Some infants with a RICH only need to be monitored as the growth involutes. The typical RICH disappears by 12 months of age. However, there are cases when treatment may be necessary. If the RICH has excessive bleeding, it can affect the child’s heart or have other complications. Some RICH can lead to skin breakdown, which may need to be treated.

RICH do not respond well to topical medications. The most common treatment is surgical removal if there are complications. Also, in some cases, there can be excess skin or scarring after involution, which may need repair for cosmetic concerns.

If your child was born with what has been diagnosed as a rapidly involuting congenital hemangioma (RICH), but you want an expert diagnosis and treatment options, contact our team at Vascular Birthmark Institute today. We are the leading experts in vascular tumors and birthmarks in New York, offering the most advanced treatments in this specialized medical field.