Infantile Hemangiomas and Vascular Malformations
Hemangiomas and vascular malformations are anomalies made up of abnormally formed blood vessels. Often referred to as birthmarks, some are clearly visible on the skin, while others are hidden under the skin's surface. Though most are benign, these vascular anomalies can cause functional issues and lead to disfigurement. Hemangiomas and vascular malformations that are visible and large can also lead to psychological and social issues later in life. Several vascular malformations and approximately 40 percent of hemangiomas will require medical intervention at some point in a child’s life.
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What Is an Infantile Hemangioma?
Sometimes called a “strawberry hemangioma” or a “strawberry birthmark,” an infantile hemangioma is a benign tumor caused by an abnormal buildup of blood vessels. Most hemangiomas develop on the surface of the skin or just beneath it, but in rare cases, other parts of the body, including the liver may be involved. Any area of the body can be involved, and can vary greatly in shape, color and size. Hemangiomas usually are not present at birth, appearing within the first month of an infant’s life. Most keep growing for the first three to five months of life. After this period of rapid growth, hemangiomas start to slowly become smaller on their own, a process which can continue to occur until around age five. While some hemangiomas may disappear completely, many can leave behind stretched skin, discoloration, or a residual area of fatty tissue.
What Are Vascular Malformations?
Vascular malformations are irregular vascular networks defined by their particular blood vessel type. Unlike hemangiomas, vascular malformations are present at birth. They may not be seen for months or weeks after birth. Vascular malformations grow slowly and do not shrink. Types of vascular malformations that occur on or near the skin include:
- Capillary Malformations or Port wine stains (red or purple in color)
- Venous malformations
- Lymphatic malformations
- Arteriovenous Malformations
- Mixed malformations (a combination of any of the other types)
What Causes Vascular Malformations?
Vascular malformations most often occur by chance. Rarely, they may be inherited in a family as an autosomal dominant trait. This means that only one parent needs to have the gene to pass it on. If one parent has the gene, there is a 50-percent chance that a child will have the condition.
How are Vascular Malformations Diagnosed?
Vascular malformations are usually diagnosed in a physical examination by your child’s pediatrician or primary health care provider. Diagnosis is based on the growth’s appearance and if its appearance changes over time. Sometimes additional testing, such as ultrasound or magnetic resonance imaging (MRI) scan, will be used to gauge the extent of the condition.
How Are Hemangiomas and Vascular Malformations Treated?
Hemangioma treatment depends on the growth’s appearance, size and location. Small hemangiomas typically do not require treatment. In cases where hemangioma treatment is required, sometimes topical or oral medications are recommended to help control hemangioma growth and accelerate shrinking. Occasionally lasers are used to improve coloration.
Similarly, treatment of vascular malformations depends on the type and severity of the malformation. If your child has a large or life-threatening vascular malformation, it may require a combination of treatments that includes surgical removal, laser therapy, sclerotherapy and oral medication therapy.
The Division of Plastic and Reconstructive Surgery at University Hospitals Rainbow Babies & Children’s Hospital offers expert treatment for hemangiomas and vascular malformations, including surgical removal and advanced laser therapy. Furthermore, we employ a multidisciplinary team approach to treating vascular anomalies. Your child’s pediatric plastic surgeon will often work with other specialists, including pediatric dermatologists, pediatric plastic surgeons, eye doctors (ophthalmologists) and radiologists to build the best treatment plan for your child.