What you should know about hemangiomas, according to a pediatric dermatologist

Two babies are side by side, dressed identical. The baby on the left has a red mark on their head, the other baby does not.
Hemangiomas are very common, non-cancerous tumors that are found on infants. We spoke to Dr. Marilyn Liang to learn more about the different types and available treatment. (Adobe Stock/Illustration: Patrick Bibbins, Boston Children's Hospital)

When parents discover that their infant has a hemangioma, a lot of questions usually follow. To find answers for the most common questions and share some important facts about the condition, we spoke with Dr. Marilyn Liang, co-director of the Vascular Anomalies Center (VAC) and an attending physician in the Dermatology Program at Boston Children’s Hospital.

What is a hemangioma?

A hemangioma is a type of non-cancerous tumor that is commonly found in infants. It is an abnormal cluster of small blood vessels that appear on or under the skin, typically within the first three weeks of birth. The tumor — which can be either red-purple in color and slightly raised or skin-colored and flat — can continue to grow for about a year and then typically disappear, either with treatment or on its own.

Hemangiomas can have many causes but aren’t hereditary.

Where can they grow?

Hemangiomas can grow anywhere on, or in, the body. Skin hemangiomas can grow on the face, scalp, chest, and back. The location of the hemangioma can indicate how immediate treatment may be. “For example, if the hemangioma is affecting the eyelid, it could interfere with vision,” shares Dr. Liang. “That is something that we would want to treat very quickly.”

Additional locations that could require immediate treatment include the lips and genital area, as hemangiomas in these locations can cause discomfort. Hemangiomas can also develop inside the body, most commonly on the liver and the airway.

Are hemangiomas treated with medication?

There are a few options for treatment, depending on the size and location of the hemangioma. The oral medication, propranolol, is FDA-approved for use in children with hemangiomas and is considered a first-line treatment. “We typically will prescribe this before your child is 4 months old, so we can shrink the hemangioma earlier in life.”  Dr. Liang also notes that if a child stops taking the medication too early, the hemangioma can potentially grow back.

After a child is 4 months old, hemangiomas can become harder to treat medically, as they grow rapidly for the first few months of the child’s life and then slow down by the time they’re 1 year old. “We really encourage parents to bring their child in as early as possible, because once the hemangioma is fully formed, it becomes harder to shrink using medications.”

When is surgery an option for treating hemangiomas?

While surgery is a less common route, your child’s physician may recommend this if the hemangioma interferes with a vital function, if the hemangioma has ulcerated, or for other case-specific reasons. In addition to surgery, laser technology is also available to treat the appearance of the skin after the hemangioma has shrunk.

The bottom line is that hemangiomas are easily treated and the earlier they are treated, the faster they will shrink. “Since they’re so common, we have a lot of research and variations in treatment plans for each child, so the sooner you see a doctor, the better.”

To learn more, visit the Dermatology Program and the Vascular Anomalies Center (VAC)

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