What is Hemangioma? Symptoms, Causes, & Treatment

A hemangioma is a bright red birthmark made of extra blood vessels that cluster together under your skin. These benign (non-cancerous) growths are incredibly common, appearing in about 1 in 10 babies, and they're completely harmless in most cases.

Think of hemangiomas as your body's way of creating a little extra blood vessel network in one spot. While they might look concerning to new parents, these strawberry-like marks are usually just a temporary part of your child's development that will fade with time.

What are the symptoms of hemangioma?

Hemangiomas typically appear as raised, bright red patches that feel soft and spongy to the touch. Most parents notice them within the first few weeks after birth, though some may appear slightly later.

Here are the most common signs you might see:

• Bright red, raised patches that look like strawberries
• Soft, compressible texture when gently pressed
• Rapid growth during the first few months
• Blanching (turning white) when pressed, then returning to red
• Warm feeling compared to surrounding skin

Most hemangiomas start small and grow quickly during your baby's first year. After this growth phase, they typically begin to shrink and fade, often disappearing completely by age 5 to 10.

In rare cases, deeper hemangiomas might appear blue or purple instead of red, and some may cause slight swelling in the surrounding area. These variations are still normal and usually follow the same pattern of growth and regression.

What are the types of hemangioma?

Hemangiomas come in three main types, each with slightly different characteristics. Understanding which type your child has can help you know what to expect as it develops.

The most common types include:

• Superficial hemangiomas: Bright red, raised bumps on the skin surface that look like strawberries
• Deep hemangiomas: Blue or purple lumps that sit deeper under the skin
• Mixed hemangiomas: Combination of both superficial and deep components

Superficial hemangiomas are the easiest to spot and make up about 60% of all cases. Deep hemangiomas might be harder to notice at first but become more obvious as they grow.

In very rare situations, some babies might develop multiple hemangiomas, which could indicate a condition called hemangiomatosis. This requires medical attention to rule out internal hemangiomas that might affect organs.

What causes hemangioma?

The exact cause of hemangiomas isn't fully understood, but they develop when blood vessels multiply more than usual in a specific area. This happens during your baby's development, creating a cluster of extra blood vessels that form the characteristic red bump.

Several factors might increase the likelihood of hemangiomas developing:

• Being born prematurely or with low birth weight
• Being female (girls are 3-5 times more likely to develop them)
• Being of Caucasian ethnicity
• Having a multiple birth (twins, triplets)
• Having a mother who had certain pregnancy conditions

It's important to understand that hemangiomas are not caused by anything you did or didn't do during pregnancy. They're simply a variation in how blood vessels develop, and they're not preventable.

In extremely rare cases, genetic factors might play a role, especially when multiple family members have had hemangiomas. However, most cases occur randomly without any family history.

When to see a doctor for hemangioma?

Most hemangiomas are harmless and don't require immediate medical attention. However, you should have your pediatrician examine any new birthmark to confirm the diagnosis and monitor its development.

Contact your doctor right away if you notice:

• Rapid growth that seems concerning
• Bleeding or open sores on the hemangioma
• Signs of infection like pus, increased warmth, or red streaking
• Location near the eyes, nose, mouth, or diaper area
• Multiple hemangiomas appearing at once

Hemangiomas in certain locations might need special attention because they can interfere with important functions. For example, those near the eyes might affect vision development, while those in the diaper area might be prone to irritation and bleeding.

If your child has more than five hemangiomas, your doctor might recommend additional testing to check for internal hemangiomas, though this situation is quite rare.

What are the risk factors for hemangioma?

Certain factors make hemangiomas more likely to develop, though having these risk factors doesn't guarantee your baby will have one. Understanding these factors can help you know what to watch for.

The main risk factors include:

• Premature birth (especially before 32 weeks)
• Low birth weight (under 3.3 pounds)
• Female gender
• Caucasian ethnicity
• Multiple births (twins or triplets)
• Advanced maternal age
• Maternal history of preeclampsia or placental problems

Premature babies have the highest risk, with hemangiomas appearing in up to 30% of infants born before 32 weeks. This is likely because their blood vessel development continues outside the womb.

While these risk factors are helpful to know, remember that many babies with multiple risk factors never develop hemangiomas, and many babies with no risk factors do. Each case is unique.

What are the possible complications of hemangioma?

The vast majority of hemangiomas cause no complications and fade away on their own. However, certain situations might require medical attention to prevent problems or manage symptoms.

Potential complications might include:

• Ulceration (open sores that can be painful and prone to infection)
• Bleeding from trauma or scratching
• Interference with vision, breathing, or eating
• Permanent skin changes after regression
• Psychological impact from visible location

Ulceration is the most common complication, occurring in about 10% of hemangiomas. This is more likely in areas with friction, such as the diaper area or where clothing rubs.

In very rare cases, large hemangiomas might cause heart problems due to increased blood flow, or compress nearby structures. Hemangiomas near the airway might cause breathing difficulties, while those near the eyes could affect vision development.

Most complications are manageable with proper medical care, and serious complications are extremely uncommon.

How is hemangioma diagnosed?

Doctors can usually diagnose hemangiomas simply by looking at them and feeling their texture. The characteristic strawberry-like appearance and soft, compressible feel make them fairly easy to identify.

Your pediatrician will examine the birthmark and ask about:

• When you first noticed it
• How quickly it's been growing
• Any changes in color or texture
• Whether it bleeds or causes discomfort
• Your family history of similar birthmarks

In most cases, no additional testing is needed. However, if the hemangioma is in a sensitive location or if your child has multiple hemangiomas, your doctor might recommend imaging studies.

Ultrasound can help determine how deep a hemangioma extends, while MRI might be used for complex cases or to check for internal hemangiomas. These tests are painless and help doctors plan the best care approach.

What is the treatment for hemangioma?

Most hemangiomas require no treatment at all since they shrink and fade naturally over time. However, treatment might be recommended for hemangiomas that cause complications or are in problematic locations.

Treatment options may include:

• Observation with regular monitoring
• Topical medications like timolol gel
• Oral medications such as propranolol
• Laser therapy for surface improvements
• Surgical removal in rare cases

Propranolol, a heart medication, has become the gold standard treatment for problematic hemangiomas. It works by shrinking the blood vessels and is remarkably effective when started early.

Topical timolol gel might be used for smaller, superficial hemangiomas. This treatment is applied directly to the skin and can help slow growth or speed up shrinking.

Surgery is rarely needed and is typically reserved for hemangiomas that don't respond to other treatments or cause significant functional problems. Most doctors prefer to wait and see how the hemangioma develops naturally before considering invasive treatments.

How to provide home care during hemangioma treatment?

Caring for a hemangioma at home is generally straightforward and focuses on protecting the area and monitoring for changes. Most hemangiomas need minimal special care beyond normal gentle skin care.

Here's how you can care for your child's hemangioma:

• Keep the area clean and dry
• Avoid rough scrubbing or picking at the hemangioma
• Apply gentle moisturizer if the skin seems dry
• Protect from trauma with soft clothing
• Take photos regularly to track changes

If the hemangioma becomes ulcerated, keep it clean with gentle soap and water, and apply any prescribed ointments. Cover open areas with non-stick bandages to prevent further irritation.

Watch for signs of infection such as increasing redness around the edges, pus, or red streaking. These symptoms warrant immediate medical attention.

Remember that hemangiomas are benign and won't turn into anything dangerous. The goal of home care is simply comfort and preventing unnecessary complications.

How should you prepare for your doctor appointment?

Preparing for your appointment can help ensure you get the most helpful information and care for your child's hemangioma. A little preparation goes a long way in making the visit productive.

Before your appointment:

• Take clear photos showing the hemangioma's size and appearance
• Note when you first noticed it and how it's changed
• Write down any symptoms or concerns
• Bring a list of current medications
• Prepare questions about treatment options and timeline

Consider bringing photos from different time points to show how the hemangioma has evolved. This visual timeline helps doctors understand the growth pattern and make better treatment decisions.

Don't hesitate to ask about what to expect in the coming months, when to worry, and what signs warrant immediate attention. Understanding the natural course helps reduce anxiety.

If treatment is recommended, ask about side effects, success rates, and alternative options so you can make informed decisions about your child's care.

What's the key takeaway about hemangioma?

Hemangiomas are common, benign birthmarks that typically appear in the first few weeks of life and grow rapidly during the first year. The most important thing to remember is that they're harmless in the vast majority of cases.

Most hemangiomas will shrink and fade significantly by age 5 to 10 without any treatment. While they might look concerning initially, especially during their growth phase, they rarely cause serious problems.

Trust your instincts about when to seek medical care, but also trust that nature usually takes care of these birthmarks on its own. Regular monitoring with your pediatrician ensures any complications are caught early and managed appropriately.

Remember that having a hemangioma doesn't reflect anything you did wrong, and with proper care and monitoring, most children with hemangiomas go on to have completely normal, healthy skin.