HEMANGIOMA

 What are Hemangiomas?
Hemangiomas are simply a collection of extra blood vessels in or under the skin.. It is a benign growth. They may have different appearances depending on the depth of the increased numbers of blood vessels.
strawberry-hemangioma-300x218

Strawberry Hemangioma is an abnormal collection of blood vessels in the skin characterized by a bright red color and well-defined border.

cavernous-hemangioma-300x209

A Deep or Cavernous Hemangioma is a large, collection of blood   vessels beneath the skin surface characterized by a soft, bluish, or skin colored mass.

cherry-hemangioma

A non cancerous skin growth made up of clusters of dilated capillaries on the surface of the skin.  It grows on most areas of the body.   It has a bright cherry red,  small pin head size appearance. It appears most frequently after the age of 30.  A cherry hemangioma is painless and harmless.

combined-hemangioma-1

A Combined Hemangioma is a combination of a deep and superficial (strawberry) hemangioma.

How Common are Hemangiomas?
Hemangiomas are one of the most common birthmarks in newborns. Most hemangiomas are not present at birth but develop within the first few weeks to months of life. They are found in up to 10 percent of babies by the age of one.

Why do Hemangiomas Occur?
The cause of hemangiomas is unknown. In very rare instances they may run in families, but in general they are not inherited.  Hemangiomas are more common in girls than boys. They are also more commonly seen in premature infants.

TYPICAL GROWTH PATTERN OF HEMANGIOMAS:

Hemangiomas usually involute (shrink away) in time. 30% of hemangiomas will resolve by 3 years of age 50% by 5 years of age, and 80%-90% by 9 years of age. Over one-half of hemangiomas heal with an excellent cosmetic result without treatment.

Which Hemangiomas Need Treatment?
In most cases, we do not recommend treatment. Some hemangiomas, however  can cause significant problems. Scenarios that may be more complicated and require treatment include:

1.     Involvement of a vital organ, like the eye or ear, or windpipe
2.     Bleeding
3.     Ulceration
4.     Crusting or infection
5.     Rapid growth and deformity of the surrounding tissues

Laser treament for Hemangioma
The goals of laser treatment are to completely remove the lesion, set the stage for further treatments, treat complications or treat the inevitable broken blood vessels (telangiectasias) left behind as a hemangioma involutes.

The pulsed dye laser (see PDL) with a dynamic cooling device is the mainstay for treatment of the superficial vascular component of the hemangioma. It can be used to slow the proliferation, reduce the redness and set the stage for other treatments.

Multiple treatments are typically needed. Depending on the lesion, age of the child and location, the treatments may be done with or without anesthesia. The least traumatic and safest way is chosen for each patient.

The PDL can be used to help heal hemangiomas that have ulcerated (the skin has broken open).This is particularly helpful for lesions in the diaper area.

For Cherry hemangiomas, several  lasers exist The most effective are the 532 nm KTP and the  940 nm Diode wavelengths. One session is sufficient.  This has replacece the more traditional treatments by electrosurgery , shave excision or cryotherapy.

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