Bruce P.Robinson, MD

Hemangiomas / Angiomas / Red Spots

Hemangiomas/Angiomas are growths of blood vessels and other red spots which can be dilated blood vessels that take the form of a birthmark (Nevus Flameus).

Hemangiomas is a bright red birthmark that shows up at birth or in the first or second week of life. It looks like a rubbery bump and is made up of extra blood vessels in the skin. A hemangioma can occur anywhere on the body, but most commonly appears on the face, scalp, chest or back. It can grow out of proportion to the child for the first 8 months of life before the growth rate levels off. Therefore, it is important to evaluate these growths early especially if they are located around the eyes, mouth, genitals, scalp, neck or anus. Many hemangiomas disappear by age 5, and most are gone by age 10. The skin may be slightly discolored or raised after the hemangioma goes away.

Red bumps that we acquire with age or genetics are referred to as cherry angiomas. They often arise later in life and while not dangerous, can be considered unsightly. Their treatment can be simple and often requires no wound care enabling one to return to daily activities immediately.

Diagnosis

A doctor can usually diagnose a hemangioma just by looking at it. Tests usually aren't needed.

Causes

A hemangioma is made up of extra blood vessels that group together into a dense clump. What causes the vessels to clump isn't known.

Risk factors

Hemangiomas occur more often in babies who are female, white and born prematurely.

Complications

Occasionally, a hemangioma can break down and develop a sore. This can lead to pain, bleeding, scarring or infection. Depending on where the hemangioma is situated, it may interfere with your child's vision, breathing, hearing or elimination, but this is rare.

Treatment

Treating hemangiomas usually isn't necessary because they go away on their own with time. But if a hemangioma affects vision or causes other problems, treatments include medications or laser surgery:

  • Beta blocker drugs. In small, superficial hemangiomas, a gel containing the drug timolol may be applied to the affected skin. A severe infantile hemangioma may disappear if treated with an oral solution of propranolol. Treatment usually needs to be continued until about 1 year of age. Side effects can include high blood sugar, low blood pressure and wheezing.
  • Corticosteroid medications. For children who don't respond to beta blocker treatments or can't use them, corticosteroids may be an option. They can be injected into the nodule or applied to the skin. Side effects can include poor growth and thinning of the skin.
  • Laser surgery. Sometimes laser surgery can remove a small, thin hemangioma or treat sores on a hemangioma.

If you're considering treatment for your child's hemangioma, weigh the pros and cons with your child's doctor. Consider that most infantile hemangiomas disappear on their own during childhood and that treatments have potential side effects.

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