Hemangiomas

If you have just been told that your child has a hemangioma, you probably have many questions and concerns. Most parents have never heard the term and have little knowledge about the treatment or outcomes. This page is intended to give you information about your child's condition.

What is a Hemangioma?

A benign tumor of dilated blood vessels. It is the most common tumor of infancy. Hemangiomas can be superficial (strawberry), deep or a combination of both. About 30% of these lesions occur on the face.

What causes hemangiomas?

No one knows for sure. Recent evidence links some genetic tendencies but this is not a strong trait. It is not the parent's fault.

What is the occurrence rate in infants?

One of every ten children is affected by hemangiomas. They are more common in females than males, 3:1. Ten to 20% of premature infants may present with hemangiomas.

What is the "life cycle" of a hemangioma?

Generally, hemangiomas present shortly after birth as a flat, red spot and may grow until 6 to 12 months of age. The involutional (or shrinking) phase usually begins at 6 to 18 months, but may not begin shrinking until 12 to 24 months of age. The involutional process may last longer than 5 years of age although 50 to 65% of all hemangiomas involute by 5 years of age.

All hemangiomas are different--different sizes, different areas of the body--therefore, different involutional results occur.

What are the most common problems?

Ulcerations: Occasionally (< 5% of patients), the hemangioma will outgrow its blood supply resulting in a small sore or ulceration. If the hemangioma does become ulcerated, it should be washed with a mild soap and water 2 to 3 times a day, and then an antibiotic ointment (Polysporin, bacitracin) should be applied to keep the sore moist. If scabbing is present, this must be soaked off with mild soap and water. The ulceration is very painful and may take several weeks to heal, but if left untreated, the sore can grow in size. You may give your child acetaminophen (Tylenol) for discomfort.

What if the hemangioma is traumatized?

It will bleed like any other cut on the skin. Although the bleeding may be steady, simply hold pressure and take your child to the Emergency Room if the bleeding does not stop within 10-minutes. Any laceration can be sutured.

All hemangiomas are different--different sizes, different areas of the body--therefore, different involutional results occur.

What are the most common problems?

Ulcerations: Occasionally (< 5% of patients), the hemangioma will outgrow its blood supply resulting in a small sore or ulceration. If the hemangioma does become ulcerated, it should be washed with a mild soap and water 2 to 3 times a day, and then an antibiotic ointment (Polysporin, bacitracin) should be applied to keep the sore moist. If scabbing is present, this must be soaked off with mild soap and water. The ulceration is very painful and may take several weeks to heal, but if left untreated, the sore can grow in size. You may give your child acetaminophen (Tylenol) for discomfort.

What if the hemangioma is traumatized?

It will bleed like any other cut on the skin. Although the bleeding may be steady, simply hold pressure and take your child to the Emergency Room if the bleeding does not stop within 10-minutes. Any laceration can be sutured.

What are the treatment options?

Time: There is much on the Internet to suggest early intervention. We are certainly not adverse to early intervention in selected circumstances, but feel that wide spread early intervention is abusive and a total disservice to the patient. The majority of hemangiomas will have complete regression without any form of treatment.

Steroids: Hemangiomas near the eyes, nose, mouth, or genitalia may require treatment with a six week coarse of oral steroids to halt the growth of the lesion.

Laser: Lasers have proven to be very effective in halting the growth of the hemangioma. However, lasers only penetrate the top 2 to3mm of tissue and are therefore limited for use on hemangiomas that are flat in nature.

Surgery: Our goal is to avoid surgery if possible, but at the same time avoid social scars and functional disability in early childhood. Hemangiomas that have ulcerated and scarred or have not involuted by the time the child enters kindergarten or first grade may require surgery. Generally, it is best to wait until the completion of the involutional phase and then evaluate the need for surgery.

Again, The majority of hemangiomas will have complete regression without any form of treatment. A wait and see approach often spares the child surgical intervention. This approach tries to give the child every opportunity to heal without a scar, however, we absolutely do not want any functional disability from social scaring when entering school.

If the lesion is still present by 4 years of age, then plastic and/or reconstructive procedures can be done to prepare your child for the start of school. Psychological impairment is most prone to occur once the child begins kindergarten and or first grade.

Is there any support for the children or families?

Children's Medical Center of Dallas offers various areas of support to children and their families. A social worker is available if families have questions regarding the family's ability to optimally meet the child's special health care needs. Also 24-hour basis there is spiritual support available to patients and families through Pastoral Support. If you have any questions, please call our office at 214.456.8888.


Be very careful when utilizing the Internet to gain insight into your child's condition. The Internet, while being very informative, can be equally uninformative. The Internet can provide you with information on your child's condition, but it does not address the needs of your particular child. Each child is unique and no two children follow the same course. The Internet will typically show you the most spectacular (and usually worst) cases for "shock value". Individual evaluation by a specialist is critical.

Dr. A. Jay Burns, M.D.
Director, Vascular Anomalies Clinic


The Fogelson Plastic Surgery &
Craniofacial Center for Children
Children's Medical Center of Dallas
6300 Harry Hines Boulevard
Suite 600
Dallas, Texas 75235