A hemangioma is a type of birthmark, usually on the head or neck, which appears shortly after birth, grows rapidly, and slowly disappears, usually before puberty. The mark is a cluster of blood vessels that form abnormally.

If your child develops a birthmark that grows, consult a doctor. This is a potentially serious condition that may require medical treatment to allow proper development of nearby organs.

Causes

It is not known what causes hemangiomas to appear, grow, or disappear.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Your baby is more likely to have a hemangioma if it is female, Caucasian, and/or premature.

Symptoms

If your child experiences any of these symptoms, do not assume it is due to hemangioma. These symptoms may be caused by other, more or less serious health conditions. Symptoms include:

• A red "strawberry" or purple bump on the skin, that may continue to grow and spread (sign of a superficial hemangioma)

• A bluish swelling under the skin (sign of a deep hemangioma)

The vast majority of hemangiomas are benign and resolve on their own without a trace by a child’s first birthday. A small minority, however, may lead to complications. Large and/or rapidly growing hemangiomas may lead to ulceration, scarring, and disfigurement.

Depending on their location, some hemangiomas may interfere with the growth and function of structures nearby (eg, eyes or airway), or may be associated with additional hemangiomas or other problems affecting internal organs. Hemangiomas of the face may be associated with abnormalities of the blood vessels of the eye or brain, and your physician may wish to do an MRI or other study to determine if such changes are present.

Diagnosis

The doctor will ask about your child’s symptoms and medical history, and perform a physical exam. Most cases of superficial hemangiomas are obvious on inspection. If there is any question of the diagnosis, particularly for deep hemangiomas, your doctor may recommend testing. Tests may include:

• CT Scan – an x-ray test that uses computers to create detailed images of a deep hemangioma, surrounding tissues and other organs that may be affected

• MRI – a test that uses powerful magnets and radio waves to create detailed images of other internal organs that may be affected

• Angiography – the use of a dye injected into a vein along with the help of x-rays, CT scan, or MRI to identify other hemangiomas internally

Treatment

Treatment options include:

Lasers – work best for superficial hemangiomas

Steroid Drugs – preferably given locally by injection, but may be given orally for large or rapidly growing hemangiomas

Recombinant Interferon Alfa – a drug that affects the immune system, usually used when steroid drugs fail or cannot be used

Prevention

While there is no way to prevent hemangiomas, they are more common in premature infants. To help reduce your baby’s chances of developing a hemangioma, follow your doctor’s advice to avoid premature birth.

One study showed a higher risk of developing a hemangioma for infants subjected to chorionic villi sampling, used to detect birth defects during the pregnancy. Women who are considering chorionic villi sampling should discuss this risk with their doctors.

RESOURCES:

American Academy of Dermatology
http://www.aad.org

Vascular Birthmarks Foundation
http://www.birthmark.org

CANADIAN RESOURCES:

BC Health Guide
http://www.bchealthguide.org

Sturge-Weber Syndrome Community Canada (SWSCC)
http://swscommunitycanada.org

References:

Bruckner AL, Frieden IJ. Hemangiomas of infancy. J Am Acad Dermatol. 2003;48:477-493.

Burton BK, Schulz CJ, Angle B, et al. An increased incidence of haemangiomas in infants born following chorionic villus sampling (CVS). Prenat Diagn. 1995;15:209-214.

Haggstrom AN, Frieden, IJ. Hemangiomas: Past, present, and future. J Am Acad Dermatol. 2004;51: S50-52.