A hemangioma of the skin is an abnormal buildup of blood vessels on or under the surface of the skin. A hemangioma of the skin may look like a red wine- or strawberry-colored birthmark, and may protrude from the skin. Hemangiomas of the skin appear most frequently on the face, neck, and behind the ears.
Growths in the outermost layers of skin are capillary hemangiomas. Those deeper in the skin are cavernous hemangiomas. Capillary hemangiomas are often left untreated, but cavernous growths should receive treatment if they interfere with eyesight or breathing.
Hemangiomas of the skin generally develop during infancy. They can affect both boys and girls.
Hemangiomas look painful, but rarely cause any discomfort. After a brief period of rapid growth, they often shrink and go away on their own without treatment. They’re non-cancerous and complications are very rare.
Experts don’t know why these benign tumors form. However, according to the Children’s Hospital of Wisconsin, they are more common in:
- infants with low birth weight
- premature infants
- Caucasian infants
In some cases, hemangiomas run in families. They can also appear spontaneously, so there may be a genetic component to the condition. There’s no way to prevent hemangiomas of the skin because their exact cause is unknown.
Hemangiomas of the skin are generally deep red or purple. They appear as raised lesions or tumors on the skin. The deeper the hemangioma, the darker it appears in color. Growths on the skin’s surface (strawberry or capillary hemangiomas) are usually deep red. Growths under the skin’s surface (cavernous hemangiomas) appear as blue or purple spongy masses filled with blood.
Hemangiomas are usually small, but can grow to be quite large. They normally begin as small scratches or red patches on the skin that form during the first two or three weeks of life. Hemangiomas in infants tend to grow rapidly for the following four to six months.
After this period of growth, hemangiomas enter a resting phase. They usually remain the same size for several months or years and then begin to shrink.
A doctor can diagnose a hemangioma of the skin just by looking at it. No other testing is usually necessary. Your doctor may order blood tests or a skin biopsy if a growth appears to be abnormal or other sores are present. A skin biopsy involves removing a small piece of skin for testing.
An MRI or CT scan is a way to examine a cavernous hemangioma. These scans allow doctors to visualize structures beneath the skin to see how deep the hemangiomas have grown.
Your doctor may also use a Doppler ultrasound to see how blood flows through a hemangioma. This allows them to distinguish between a hemangioma and other, similar lesions, such as those caused by rubella, measles, or acrodermatitis. A Doppler ultrasound may also help determine if the hemangioma is growing, resting, or shrinking.
Capillary hemangiomas aren’t usually treated. As the child gets older, the growth tends to shrink and will usually disappear on its own.
If a cavernous hemangioma is in an area that could interfere with sight or breathing, treatment may be necessary. Treatment might also be necessary if the hemangioma is very large or breaks open and bleeds, causing discomfort.
Treatments can shrink or remove the growth. Laser surgery can remove a large hemangioma of the skin that’s uncomfortable or is causing problems. Laser treatments can also reduce remaining discoloration after a hemangioma has healed.
If the hemangioma is growing quickly, corticosteroids such as prednisone can slow or stop the growth. They may be given orally, applied topically, or injected into the hemangioma. The potential side effects of these medications are serious and may include poor growth, high blood sugar and blood pressure, and cataracts. These side effects are given careful consideration before being prescribed.
A medication called vincristine, which treats other types of tumors, also sometimes treats hemangiomas that interfere with sight or cause breathing problems. It usually comes in the form of a monthly injection.
Complications from hemangiomas are extremely rare. However, they can occur if a hemangioma grows very quickly or is in a dangerous location. Potential complications include:
- ulceration (bleeding)
- vision changes (if the hemangioma is on the eye)
- difficulty breathing (if the hemangioma is large and on the throat or nose)
- secondary infection
Most hemangiomas will go away by themselves in time. If you decide that your child needs treatment, discuss options with your doctor. Treatment depends on careful evaluation and observation by a doctor.