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Hemangiomas are abnormal overgrowths of blood vessels that can appear as red or purple lumps in the skin and on other parts of the body.
Hemangiomas of infancy are very common. Hemangiomas also develop during middle age and later, especially on the trunk.
These angiomas are the most common tumor of infancy, affecting 10 to 12% of infants by 1 year of age. Hemangiomas of infancy develop soon after birth and tend to enlarge rapidly during the first year of life. After 12 to 18 months, they begin to shrink. About 70% of hemangiomas disappear by age 7, although the skin that remains is often slightly discolored or scarred.
Hemangiomas of infancy grow within and under the skin. They cause the skin to bulge and become bright red or, if they are very deep, bluish. Most deep hemangiomas grow between ¼ and 2 inches (0.5 and 5 centimeters) across, although sometimes they grow much larger. More than half occur on the head and neck. Sometimes, hemangiomas develop in organs, such as the liver (see Hemangiomas of the Liver).
Hemangiomas of infancy do not cause pain but occasionally break open (ulcerate) and bleed. Hemangiomas around the eye may grow large enough to block vision, which can lead to permanent vision loss if uncorrected. Hemangiomas may also block the nose or throat, which can block breathing.
Doctors may do magnetic resonance imaging (MRI) if the hemangioma seems to be blocking the nose or throat or another important structure.
Typically, hemangiomas of infancy completely shrink by the time the child is 10 years old. Because hemangiomas of infancy usually go away on their own, doctors may not treat them when they first appear unless they grow rapidly, block vision or breathing, ulcerate, or are cosmetically distressing.
When treatment is required, doctors may prescribe corticosteroids that are applied to the skin, injected, or taken by mouth; laser treatments; or propranolol taken by mouth. Hemangiomas that have ulcerated are treated with compresses, drugs that are applied to the wound, and dressings. Surgical removal is usually not recommended because the vast majority of hemangiomas go away on their own and there is less scarring when they are left alone. For older children in whom the hemangioma has shrunk to the greatest degree, surgery may improve the appearance of the skin.
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