Hemangiomas are a kind of tumor formed by extra blood vessels. They are the most common benign tumor of infants. Usually, they occur on the surface of the skin (strawberry hemangiomas). Those that are deeper in the skin are called cavernous hemangiomas. Strawberry hemangiomas are bright red (or purple), soft, raised, squishy birthmarks with sharp borders. They are most common on the head, chest, or upper back. Cavernous hemangiomas often appear bluish, and the borders look less distinct. Most are found on the head or neck.
Most children with hemangiomas have only one. Rarely, children have many. Hemangiomas may be on the skin or in the internal organs.
Most hemangiomas appear within a week or two after birth. Only 2% are actually visible at birth. It is usually noticed as a small red blemish or bump that may look like a bruise or scratch, but quickly begins to grow. Usually there are two growth cycles: 0 to 4 months for the first cycle, with a pause from 4 to 6 months and then a second growth, from 6 to 12 months. Between 12 months and 18 months of age, some hemangiomas may start turning gray. This is a sign that it is getting smaller.
Port wine stains and other birthmarks are not hemangiomas.
No one knows the exact cause. Hemangiomas tend to run in families, and occur more frequently in lighter skinned than darker skinned infants. Hemangiomas are about 3 times more common in girls than boys, and are also more common in premature infants.
Usually a solitary hemangioma is not harmful. All hemangiomas should be checked by a healthcare provider. Infants who have 3 or more small hemangiomas should be checked for internal hemangioma of the liver or digestive tract. Internal hemangiomas can lead to heart failure or other organ problems.
Several problems may require immediate treatment, such as if the hemangioma blocks the eyes, ear canal, or airway, or if it interferes with feeding. Your child may also need treatment if he or she has bleeding, pain, or facial disfigurement.
About half of all hemangiomas will get smaller by age 5 even without treatment. Those that do not get smaller by the age of 3 to 5 years may take up to 10 years to go away. They can also leave scars. Treatment options include surgery, laser treatments, or steroid therapy.