Should I be worried about my child’s hemangioma?

Jerusalem Vascular Hemangiomas

Hemangiomas are very very common and affect about 5% of all newborn children. The overwhelming majority are called ‘infantile hemangiomas’ or IH’s.

IH’s can appear anywhere on your child’s body and typically appear after a few weeks of age. IH’s typically get larger and darker in color (usually red) for about 6-12 months and although this may be alarming to parents, it is usually of no clinical concern. The IH typically begins getting smaller and lighter in color at about 1 year of age and this process may take several years. The IH may go away completely or leave a small visible mark on the skin. Because they regress on their own, most IH’s do not require any treatment.

A small number of IH’s may cause problems such as bleeding or skin ulceration. In this case, your physician may recommend a medication called propranolol which slows the growth of these lesions duing their phase of growth (“proliferative phase”) in the first few months of life.

A very small percentage of IH’s may be associated with rare syndromes and should be further evaluated. Some warning signs include IH’s on the face,and  multiple IH’s in different parts of the body.

There are other rarer types of hemangiomas called Congenital Hemangiomas (CH’s). CH’s are typically maximal size at birth (they do not grow rapidly in the first few months like IH’s). They are further described by how much they regress. For example, a rapidly-involuting congenital hemangioma (RICH) will regress fairly rapidly whereas a non-involuting congenital hemangioma (NICH) will not regress, and a partially-involuting congenital hemangioma (PICH) will regress partially. Depending on their location and other problems that may occur, CH’s may require surgical treatment +/- a catheter-based procedure to block off the blood vessels supplying them.

While most hemangiomas require only accurate diagnosis and reassurance, they should be seen by a specialized physician in order to best advise you what to expect, and if treatment is recommended.

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