Q: My daughter developed numerous hemangiomas, most of them on her face and stomach, when she was a few months old. She's now 6 years old, and they have not gone away.
She is self-conscious about them, and people are always asking about her condition. Is there a safe way to surgically remove them? Will she have them her whole life? I had been told they should resolve on their own before she was in school.
A: Even though they usually are not present at birth, hemangiomas are considered a type of birthmark. Typically these red marks on the skin grow during a child's first year of life, and then begin to slowly shrink and fade. Hemangiomas can take a long time to go away, though, and in some cases, they never disappear completely. There are ways to remove hemangiomas that last or that cause problems.
Hemangiomas are caused by an abnormally dense group of extra blood vessels. Many hemangiomas appear as flat, red marks on the skin during the first several weeks or months of life. They can be on any part of the body but are most commonly on an infant's face, scalp or neck.
A hemangioma often grows quickly in the first months of life, becoming a spongy mass that is raised above the skin. Growth typically slows after several months. By the time a child reaches his or her first birthday, hemangiomas commonly stop growing and begin to recede.
Hemangiomas usually don't cause health problems, nor do they typically signal an underlying medical condition. In some cases, a hemangioma may interfere with a child's vision if it is near an eye, or it could cause feeding problems if it's near the mouth. Rarely, hemangiomas can develop inside a person's body, most often in the liver. But most do not require treatment.
In general, the odds of hemangiomas being reabsorbed into the body are about 10 percent each year. That means at age 6, 40 percent of children with hemangiomas still have them. Nearly all hemangiomas are gone by the time a child reaches age 10. So the possibility remains that the hemangiomas your daughter has will go away on their own. But, it is also a possibility that her body has taken away all of the hemangiomas that it can and what remains, called residua (usually made up of fat), will not go away on its own.
At this time, it would be useful for you to talk with a dermatologist or a pediatric dermatologist. He or she can assess your daughter's condition and help you decide if treatment is needed. Hemangiomas can be removed with surgery or by using laser treatment.
Both procedures are safe and effective. In many cases, laser treatment is preferable because it does not typically leave a scar. Hemangioma removal is usually covered by insurance.
If you decide not to have the hemangiomas removed, your daughter's doctor should monitor them at her checkups. Also, contact her doctor if a hemangioma bleeds, forms a sore or bruise, becomes firm, appears infected, or grows suddenly over one or two days. These symptoms should be evaluated promptly to ensure there are no other underlying problems.
Learn more about birthmarks: The Mayo Clinic website contains more information on hemangiomas and other birthmarks. Go to mayoclinic.com.
Dr. Dawn Davis is a dermatologist with the Mayo Clinic in Rochester, Minn.
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