The Vascular Lesion Center at Lurie Children’s treats a wide range of vascular tumors. The most common vascular growth that is seen in infancy is an infantile hemangioma. An infantile hemangioma is a collection of dilated (enlarged) blood vessels. Infantile hemangiomas occur more often in females than males and are also more common in premature babies and twins. They may be present when your child is born, but most develop within the first few weeks of life. Often, before the hemangioma appears there may be an area onr child’s skin that appears bruised, reddened or has a pale appearance. Most hemangioma growth occurs in the first three months of a child’s life, but some may continue to grow in size for many more months.
After growing, infantile hemangiomas will begin an involution (shrinking) phase. This can be hard to notice at times, but a parent may notice a change in color of the hemangioma, warmth or firmness. By about ten years of age, 90% of infantile hemangiomas will have completed their involution phase. Some hemangiomas may shrink and leave nearly normal-appearing skin, while many leave permanent changes to the skin.
Infantile hemangiomas can be located anywhere on a child’s body, including internal organs. Infantile hemangiomas that occur on the lip, ear, nose or forehead can cause changes to a child’s appearance that may require medical treatment and less commonly surgery. Having a hemangioma located on certain areas of the body can suggest other health issues that may occur along with the hemangioma. Syndromes such as PHACE, or LUMBAR- PELVIS-SACRAL, may have a range of other health concerns that will be addressed by your doctor.
The most common problem that occurs with infantile hemangiomas is ulceration, or a breakdown of the skin. It can cause pain, bleeding, infection, and scarring. There are many options for treating ulcerated hemangiomas, such as topical medications and dressings, oral medications, as well as oral antibiotics and laser treatments.
Though infantile hemangiomas begin to shrink over time, there are multiple treatments available to help decrease complications, if needed. Ideally, treatment is started early, before any permanent skin changes occur. Some of the most common treatments include but are not limited to: topical timolol, injection of corticosteroids, oral medications (propranolol or corticosteroids), pulsed dye laser and surgical procedures.
When oral therapy is needed for appearance or function-threatening lesions, propranolol may be suggested. This treatment is very successful in stopping hemangioma growth and shrinking them. Pulsed dye laser treatments can also be used for certain hemangiomas. Surgical procedures may be recommended to correct skin or structural changes that may occur.
Although most infantile hemangiomas do decrease in size, they can be quite challenging for families to deal with. The effect on your child’s appearance and your concerns with ongoing care can cause stress. It can be distressing during the time that the hemangioma is increasing in size, as well as waiting for it to begin decreasing. It is important to have your child seen by a doctor who sees these lesions regularly and understands the treatments available.
The Vascular Lesion Center has a social worker, as well as a psychologist as part of the team to assist you in caring for your child. There are also multiple support groups available to help. Links to support group websites can be found on the vascular lesion webpage.
If you’d like to request an appointment with one of our specialists from the Vascular Lesion Center, call 1.312.227.8521.