Rapidly involuting congenital hemangiomas (RICH) are rare vascular tumors present at birth, often appearing as raised, pink or bluish growths that feel warm to the touch. Led by Dr. Waner and Dr. O, the Vascular Birthmark Institute offers expert diagnosis and personalized care for RICH and other vascular anomalies.
What is Rapidly Involuting Congenital Hemangioma (RICH)?
A rapidly involuting congenital hemangioma (RICH) is a rare vascular tumor that forms in utero and is fully developed at birth. Unlike infantile hemangiomas, RICH do not grow after birth and begin shrinking rapidly within the first few months of life, often disappearing by one year of age. These tumors usually appear as round or oval lesions with a pink or bluish hue and are warm to the touch. Accurate diagnosis by an experienced vascular specialist is essential, as RICH can sometimes be mistaken for other conditions.
Signs & Symptoms of Rapidly Involuting Congenital Hemangioma (RICH):
- Present at birth as a fully formed vascular tumor
- Raised, round, or oval-shaped lesion
- Pink, purple, or bluish hue to the skin
- Warm to the touch
- Surrounded by a ring of paler skin
- Most commonly located on the scalp, forehead, ears, arms, or legs
- Size varies from small to large, sometimes covering an entire joint
- Typically begins to shrink (involute) within the first few months of life
- Potential for skin breakdown or bleeding in some cases
Treatments for Rapidly Involuting Congenital Hemangioma (RICH)
At the Vascular Birthmark Institute, our first step in treating a rapidly involuting congenital hemangioma (RICH) is to ensure an accurate diagnosis. Dr. Waner and Dr. O will carefully evaluate your child’s growth through a physical examination and medical imaging if needed. Once the diagnosis is confirmed, we curate a personalized treatment plan based on the size, location, and behavior of the RICH, along with your child’s overall health.
Observation and Monitoring
In most cases, if the RICH is not causing any complications, the best course of action is careful observation. You will have regular follow-ups so we can monitor the involution process, which means how quickly and completely the growth shrinks. Most RICH tumors naturally disappear by the time your child is 12 months old without needing any active treatment. During this time, we check for signs of complications such as bleeding, ulceration, or rapid changes in size.
Surgical Removal
If the RICH develops complications such as significant bleeding, heart strain, or skin breakdown, surgical intervention may be recommended. Surgical removal involves carefully excising the tumor under anesthesia. During surgery, we remove the abnormal blood vessels and surrounding tissue if necessary, while preserving as much healthy tissue as possible. This procedure helps prevent ongoing damage to the skin and underlying structures, protects your child’s health, and can improve cosmetic appearance when needed.
Repair of Excess Skin or Scarring
After a RICH has involuted, there may be residual stretched skin or scarring left behind. If this creates cosmetic concerns or causes functional issues, we offer surgical repair options. In these procedures, we carefully remove the excess skin or revise scar tissue to restore a more natural appearance. These techniques are customized to match your child’s skin texture, tone, and location of the previous lesion, helping them achieve the best aesthetic results as they grow.
Schedule Your Consultation
Vascular Birthmark Institute is a world-renowned center specializing in the diagnosis and treatment of vascular tumors and birthmarks. Led by Dr. Waner and Dr. O, our team is dedicated to providing expert care tailored to your child’s needs. If your child was born with a growth that may be a rapidly involuting congenital hemangioma (RICH), we are here to help with advanced diagnostic tools and treatment plans. Contact us today to schedule your consultation and ensure your child receives the best care for their RICH.
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