Hemangiomas in Infants: Causes, Treatment, and Prognosis

Hemangioma

Doctor, my friend's daughter just turned 2 months old, and there is a small red spot on the right side of her forehead.
They didn't notice it at birth and thought it was a birthmark.
They took her to see a doctor, who said it was nothing to worry about and that it would disappear as she grows up.
Is that true? What causes a hemangioma, and why does it occur? Is it hereditary, or is there another reason? Could you please help me with these questions? Thank you.
Also, can hemangiomas be treated? Is laser treatment necessary, or are there other options?

Ping Ping, 20~29 year old female. Ask Date: 2004/04/01

Dr. Zhao Yongkang reply Pediatrics

Dear Miss Pingping,
1.
A hemangioma is caused by the abnormal proliferation and aggregation of microvessels.
It typically manifests on the skin, but it can also occur in internal organs.
Generally, it is not related to genetics.
2.
If it is a flat hemangioma, it often resolves naturally as children grow older.
If there are concerns about appearance, you may consult a dermatologist for evaluation; laser treatment is one of the options available.
3.
I recommend that you have your child examined by a dermatologist, as a typical hemangioma should not be purulent.
Thank you for your letter!
Wishing you peace,
Dr.
Chao Yong-Kang
Director of Pediatrics
Hsinchu Hospital

Reply Date: 2004/04/01

More Info

Hemangiomas are benign vascular tumors that are quite common in infants, particularly in the first few months of life. They often appear as red or purple marks on the skin and can vary in size. Understanding hemangiomas involves looking at their causes, treatment options, and prognosis.

Causes of Hemangiomas
The exact cause of hemangiomas is not fully understood, but they are believed to arise from an abnormal proliferation of endothelial cells, which are the cells that line blood vessels. These tumors typically develop shortly after birth and can grow rapidly during the first year of life. They are more common in females than in males and are often seen in infants who are premature or of low birth weight. There is no strong evidence to suggest that hemangiomas are hereditary, although some studies indicate a possible genetic predisposition.

Treatment Options
In many cases, hemangiomas do not require treatment and will resolve on their own as the child grows. Most hemangiomas undergo a process called involution, where they gradually shrink and fade over time, usually by the age of 5 to 10 years. However, if a hemangioma is large, located in a sensitive area (such as near the eyes or mouth), or causing functional problems, treatment may be necessary.

1. Observation: For many small hemangiomas, especially those that are not causing any issues, doctors may recommend a "watch and wait" approach. Regular monitoring is essential to ensure that the hemangioma is not growing or causing complications.

2. Medications: In some cases, oral medications such as propranolol (a beta-blocker) have been used successfully to treat problematic hemangiomas. Propranolol can help reduce the size of the hemangioma and promote faster involution.

3. Laser Therapy: For hemangiomas that are causing cosmetic concerns or complications, laser therapy may be an option. Laser treatments can help reduce the redness and size of the hemangioma, especially when it is located on the face.

4. Surgery: In rare cases, surgical intervention may be necessary, particularly if the hemangioma is large and causing significant issues or if it does not respond to other treatments.

Prognosis
The prognosis for hemangiomas is generally very good. Most will resolve completely without any intervention, leaving little to no scarring. However, the timeline for involution can vary significantly from one child to another. It is essential for parents to have realistic expectations and to consult with a pediatric dermatologist or a specialist in vascular anomalies if they have concerns about their child's hemangioma.

Conclusion
In summary, hemangiomas are common in infants and often resolve on their own. While the exact cause is not known, they are not typically hereditary. Treatment is usually not necessary unless the hemangioma is causing problems. If your friend's daughter has a small hemangioma on her forehead, it is likely that it will fade over time, as many do. Regular follow-ups with a healthcare provider can help monitor its progress and determine if any treatment is needed in the future. If there are any concerns about the hemangioma's appearance or growth, it is advisable to seek further evaluation from a specialist.

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