Infantile Hemangioma

What are the signs and symptoms of infantile hemangioma?

The most obvious sign of an infantile hemangioma is a red or blue mark that grows rapidly within the first few weeks to months of life. It may appear like a birthmark that slowly raises from the skin, and the area may be warm to the touch. Infantile hemangiomas can sometimes resemble other vascular anomalies, but their rapid growth phase followed by slow disappearance is unique.

Though infantile hemangiomas can resolve completely, some do not. Bulky bumps or skin changes may remain later in life. The size and location of the tumor may require more active treatment than watchful management.

Without proper monitoring and treatment, infantile hemangiomas can lead to complications including bleeding, ulcers, infection and impaired breathing or vision, depending on the location. Infantile hemangiomas on the face, neck or in the diaper area need quick attention.

How do we diagnose infantile hemangioma?

We typically diagnose infantile hemangiomas by clinical history and a physical exam. In some cases, our doctors may use imaging tests such as ultrasound or magnetic resonance imaging (MRI) to identify depth and blood flow patterns or if the tumor is affecting other tissues or organs.

What can I expect from infantile hemangioma testing?

Our experts prioritize the comfort of your child and use child-friendly equipment and techniques to reduce anxiety. Most tests are noninvasive and brief, while MRI scans can sometimes take an hour or two. If anesthesia is necessary during any of these tests, especially in younger children, we’ll provide imaging guidelines beforehand.

How do we treat infantile hemangioma?

Some infantile hemangiomas do not need treatment and will shrink naturally. However, treatment options are available if the infantile hemangioma is causing issues in your child’s daily life. Those options include:

• Propranolol: This medication taken by mouth can reduce tumor size. Kids sometimes take propranolol past their first or second birthday for deeper or larger infantile hemangiomas
• Timolol: You can apply this medication to the surface of smaller or thinner infantile hemangiomas.
• Laser Therapy: Lasers may help manage ulcers in the growing stage of the tumor. When a child is older, lasers may improve discoloration.
• Surgery: We rarely use surgery unless there’s an issue with bleeding, daily function or ulcers. Once the tumor shrinks, surgery can help remove fatty tissue or scars. Surgery is mostly for older children to ensure the tumor shrinks and to make scars as small as possible.

Why choose us for treatment of an infantile hemangioma?

While infantile hemangiomas can look alarming, our experts have a lot of experience diagnosing and treating them. We provide thoughtful guidance on when we can simply monitor the tumor and when we need a more proactive approach. At Children’s Colorado, our specialists include pediatric dermatologists and pediatric surgeons who specialize in treating vascular anomalies like infantile hemangiomas.

As one of the top pediatric vascular anomalies programs in the country, we see more children than most hospitals, and that helps us diagnose children more accurately and provide more effective treatments.

To make an appointment, please call 720-777-8628.

Helpful resources

• American Academy of Dermatology (aad.org)
• Vascular Birthmarks Foundation

Will the hemangioma go away on its own?

Yes, most infantile hemangiomas will shrink over time, but the timeline can vary. However, it is helpful for your child to be seen by a specialist with experience in infantile hemangiomas to determine if the tumor will cause problems such as a wound or differences in skin when they are older.

Is treatment necessary?

Not always. Many cases resolve without intervention. We consider treatment if the infantile hemangioma could cause functional issues or if there are concerns about future healing.

Is there a risk of the hemangioma returning after treatment?

Generally, treated infantile hemangiomas do not return. Sometimes, when we are decreasing medication, the tumor can become slightly larger again. However, new lesions aren’t common in an older child.