Hemangioma

Hemangiomas are a type of growth that can appear as red or purple lumps on lighter skin or brown on darker skin. They happen when clusters of blood vessels grow and bunch together incorrectly. You can have them when you’re born, develop them during infancy or have them appear later in life.

Hemangiomas are most common in infants and children, with about 1 in 10 babies having them at birth. But adults can develop them, too. In fact, about 3 out of 4 people age 75 and older have cherry hemangiomas.

Is a hemangioma a tumor?

Hemangiomas are a type of benign tumor. They don’t spread to other parts of your body and aren’t cancer. It’s also extremely rare for hemangiomas to turn malignant (cancerous).

What are the types of hemangiomas?

The two most common types of hemangiomas are:

• Capillary. These appear on the outer layers of your skin. These include infantile hemangiomas (strawberry hemangiomas), which are common in infants. They also include cherry hemangiomas, which are common in adults, especially over age 75.
• Cavernous. These form in deeper layers of skin, often around your eyes. When they grow near your eyes, they can sometimes affect eye development or function. That can contribute to vision conditions like amblyopia (lazy eye), glaucoma and cataracts.

Are hemangiomas dangerous?

Hemangiomas usually aren’t dangerous. But if they grow in a critical area, they can press on and eventually damage surrounding tissues, which can make them dangerous. How dangerous depends mainly on where exactly they are.

Symptoms of hemangiomas

Hemangiomas can grow just about anywhere on your body but usually grow on your head or neck. They’re most visible when they happen on your skin. But hemangiomas can also happen on mucus membranes, like inside your mouth or on your tongue. They can also grow inside your body without you ever knowing it or having symptoms. The most common place for them to grow inside you is your liver.

On your skin, they can:

• Look like a bulge or blister-like bump
• Have a bright red to purple color on lighter skin or brown color on darker skin when shallow, but sometimes are blue or bluish when deeper
• Measure between 1/4 inch to 2 inches (0.64 centimeters to 5.1 centimeters) wide
• Usually happen alone, but can happen in clusters or even larger, continuous lesions

Hemangiomas typically don’t hurt. But they may, depending on a few factors. One of those is location. Hemangiomas may hurt if they’re large or grow in places without space to spare. Hemangiomas on your skin can also hurt if you injure them, like with a scratch or scrape. Most hemangiomas also don’t bleed without injury.

Hemangioma phases

Infantile hemangiomas that develop after birth have a two-phase life cycle.

• Proliferation (first phase). During this phase, a hemangioma grows rapidly. In babies, this phase usually happens during the first 12 months of life.
• Involution (second phase). During involution, hemangiomas shrink. It usually starts when a baby is between 12 months and 18 months old. It can take years for this phase to finish. About half of babies finish it by age 5. About 9 out of 10 babies finish it by age 9.

By the time involution finishes, the hemangioma is gone. Sometimes, they vanish without a trace. But in other cases, hemangiomas will leave behind scarring or skin discoloration.

Congenital hemangiomas (which you have at birth) may disappear depending on what pattern they follow. The patterns are:

• Rapidly involuting (they go away quickly)
• Noninvoluting (they don’t go away)
• Partially involuting (they only go away partly)

Hemangioma causes

Hemangiomas happen when clusters of blood vessels form and grow incorrectly. Experts aren’t sure exactly why they happen or how they form.

Risk factors

Several potential risk factors can make hemangiomas more likely to affect you:

• Age. Hemangiomas typically affect newborns and infants, especially between 2 weeks old and 2 months old.
• Development at birth. Up to 1 in 5 premature babies will develop a hemangioma.
• Sex. Hemangiomas are up to four times more likely to affect females.
• Skin color. Hemangiomas are more common in people with lighter skin.
• Other health issues. Some conditions are likely to cause hemangiomas. Examples include PHACE syndrome or von Hippel-Lindau disease.

Complications of hemangiomas

Hemangiomas usually don’t cause any complications unless they grow in a critical location. Some examples include around your:

• Eyes. Hemangiomas around your eyes may press on and damage delicate eye tissues.
• Chin and neck. Hemangiomas on your lower face and neck may press on critical structures like your windpipe, cutting off air.
• Spine. Hemangiomas may press on or injure your spinal cord if they grow in certain places around your spine.
• Internal organs. When hemangiomas are large or you have many internally, they may disrupt or even damage your internal organs.

How doctors diagnose hemangiomas

Hemangiomas, especially ones on your skin, often stand out. Healthcare providers may notice them during routine physical exams.

Healthcare providers can assess hemangiomas using simple devices like ultrasound. This imaging method is especially useful with hemangiomas because of the blood flowing through them. Other tests, like a biopsy to test the tissue and determine what it is, are possible but not always necessary.

In some cases, your healthcare provider might recommend additional imaging like MRI. Scans like this can help your provider check for potential risks that aren’t visible from the outside. And other tests, like blood tests or even genetic tests, may help your provider diagnose a hemangioma or rule out other conditions. Your healthcare provider can tell you more about the tests they recommend for your situation.

How are hemangiomas treated?

Hemangiomas are very treatable, but many of them don’t need it. Infantile hemangiomas commonly go away on their own, so your provider may recommend monitoring only.

Some reasons why hemangiomas might need treatment include:

• Location. This is especially true with hemangiomas that could damage surrounding tissues or structures.
• Size. Larger hemangiomas may need treatment to remove and repair them.
• Appearance. It’s common for people to want visible hemangiomas, like on your face or head, removed for appearance reasons.
• Repairing lingering effects. Even when hemangiomas don’t need direct treatment, they might leave lingering tissue changes behind.
• Damage to the hemangioma. When they do bleed, proper wound care is key to helping hemangiomas heal.

There are a few ways to treat hemangiomas:

• Beta-blockers. Drugs like propranolol are a first-line treatment. When you take them during the proliferation phase, they make the hemangioma shrink. They come in oral (by mouth) or topical (on your skin) forms.
• Corticosteroids. These medications are given topically on your skin or injected. They can also make hemangiomas shrink.
• Laser treatments. Lasers can stop superficial hemangiomas from growing or even shrink them. Lasers may also be able to reduce discoloration (so the hemangioma is less visible).
• Blood supply cutoff. Providers can cut off blood flow to a hemangioma using techniques like sclerotherapy or embolization.
• Surgery. A surgeon can remove larger or deeper hemangiomas. Surgery can also repair damage or changes that a hemangioma leaves behind.

Cherry hemangiomas, the type that usually affects adults over 75, don’t generally need treatment. But if they’re causing issues for you, a primary care provider can refer you to a dermatologist for treatment.

When should I see my healthcare provider about my hemangioma?

You should schedule a visit to a healthcare provider if you have a hemangioma that:

• Changes color
• Breaks open and bleeds
• Develops near your eyes
• Develops around your mouth, chin or throat

What can I expect if I have a hemangioma?

What you can expect from a hemangioma depends on the type, where it is and when you have it. In general, hemangiomas aren’t dangerous unless they grow in certain places. And most hemangiomas will eventually shrink and fade on their own. But if your child does have a hemangioma that needs treatment, several treatment approaches are available to help.

If your child has a hemangioma and you have questions about how it might affect them, there’s someone who can help. Your child’s pediatrician can offer insight and guidance about what you can and should do to help your child. They can also reassure you and help ease your concerns.

What’s the difference between a hemangioma and a birthmark?

Hemangiomas are a type of vascular birthmark, meaning they come from blood vessels. Birthmarks can be vascular or pigmented (like moles).