Treating Hemangiomas

Expert Care for Vascular Birthmarks and Growths

A bright red birthmark on your baby’s skin isn’t always a cause for alarm. However, it’s one of the most common vascular growths pediatric dermatologists evaluate. If you’ve noticed a red, raised bump that seems to be growing, you’ll want to have it assessed by an experienced dermatologist.

Hemangiomas are benign growths that form when blood vessels cluster together incorrectly. They’re not cancerous. They rarely cause serious problems. But they can grow rapidly during infancy, and depending on their location and size, some require treatment to prevent complications.

At Connolly Dermatology, we provide expert evaluation and hemangioma treatment guided by evidence-based care. Our board-certified dermatologists assess, monitor, and treat hemangiomas, focusing on early detection of complications and appropriate intervention when needed.

If you or your child has a hemangioma that concerns you, scheduling an evaluation with a dermatologist provides clarity. Have your skin assessed by the specialists at Connolly Dermatology and get the answers you need to move forward confidently.

Understanding Hemangiomas

How These Vascular Growths Differ From Other Birthmarks

Hemangiomas form when blood vessels develop and grow incorrectly, creating a dense cluster. Instead of forming a normal vascular network, the vessels accumulate in one area and create a visible growth. They’re the most common type of vascular birthmark.

These growths have distinctive characteristics. They appear as red, purple, or brown lumps depending on your skin color and how deep they are. Superficial hemangiomas look bright red and raised—sometimes called “strawberry birthmarks.” Deeper ones appear blue or match your skin tone.

Most hemangiomas follow a predictable pattern. They grow rapidly during a baby’s first year, then slowly shrink and fade over several years. About half resolve completely by age 5, and 90% by age 9.

Infantile Hemangiomas vs. Cherry Hemangiomas

The term “hemangioma” describes different vascular growths that occur at different life stages.

Infantile hemangiomas appear at birth or within the first few weeks of life. They go through distinct growth and shrinking phases. About 1 in 10 babies develops an infantile hemangioma, with premature babies and females at higher risk.

Cherry hemangiomas are small, bright red bumps that develop in adults, typically after age 30. About 3 out of 4 people over age 75 have cherry hemangiomas. They don’t shrink on their own but rarely cause problems.

Hemangiomas vs. Other Birthmarks

Several types of birthmarks can appear red or vascular, making it important to distinguish between them.

Characteristic

Infantile Hemangiomas

Port-Wine Stains

Salmon Patches

Appearance

Bright red, raised, spongy texture

Flat, pink-to-purple discoloration

Flat, pale pink patches

Timing

Appear at birth or first few weeks

Present at birth

Present at birth

Growth Pattern

Grow rapidly, then shrink and fade

Remain stable; may darken with age

Typically fade by age 1-2

Texture

Raised, protruding from skin

Flat, at skin level

Flat, at skin level

Resolution

Most fade significantly by age 5-10

Permanent without treatment

Usually disappear spontaneously

Treatment Needs

Sometimes required if location poses risk

Often treated for cosmetic reasons

Rarely need treatment

This table summarizes common differences, but not all lesions fit every description. Any birthmark that changes or causes symptoms should be evaluated by a dermatologist.

Are Hemangiomas Dangerous?

Hemangiomas aren’t cancerous. They’re extremely rare to turn malignant. Most pose no health risk whatsoever.

However, complications can occur depending on location and size. Hemangiomas near the eyes may press on delicate eye tissues and affect vision development, potentially causing amblyopia, glaucoma, or cataracts. Those around the chin, neck, or throat may compress the windpipe and interfere with breathing. Large hemangiomas on the spine may press on the spinal cord.

This is why evaluation matters—especially for hemangiomas in critical locations or those growing rapidly.

Signs and Symptoms

Hemangiomas can vary in appearance depending on their depth, location, and stage of development. Understanding their general features helps you recognize them and know when evaluation is warranted.

Size and Shape: Hemangiomas typically measure between 1/4 inch and 2 inches wide. They can be round, oval, or irregular. Some appear as single lesions while others occur in clusters.

Color: Color depends on depth and skin tone. Superficial hemangiomas appear bright red to purple on lighter skin and brown on darker skin. Deeper hemangiomas look blue or bluish because they’re beneath the skin surface.

Texture: Superficial hemangiomas feel spongy or rubbery. Deeper ones may not be palpable at the surface. The texture changes as hemangiomas shrink—they become flatter and softer during involution.

Location: Most infantile hemangiomas develop on the head or neck. They can also appear on the chest, back, or anywhere else on the body. Some grow internally, most commonly in the liver, without visible symptoms.

Growth Patterns: Infantile hemangiomas follow predictable phases:

• Initial Appearance: Most appear at birth or during the first month of life as a flat red mark
• Proliferation Phase: Rapid growth during the first year, particularly the first five months; by 3 months, most reach 80% of their maximum size
• Involution Phase: Begins around the first birthday; hemangiomas flatten, become less red, and slowly shrink over several years

Symptoms To Watch For

Most hemangiomas are painless. They don’t cause discomfort unless they’re injured or in a location that creates pressure.

However, some complications warrant prompt evaluation:

• Bleeding or ulceration (open sores)
• Pain or tenderness
• Interference with vision, breathing, hearing, or other bodily functions
• Feeding difficulties (for hemangiomas near the mouth)
• Rapid growth that concerns you
• Multiple hemangiomas (may indicate internal involvement)

If a hemangioma bleeds, forms a sore, appears infected, or causes problems with important bodily functions, contact a healthcare provider.

Risk Factors for Developing Hemangiomas

The exact cause of hemangiomas remains unknown, though they result from abnormal clustering and growth of blood vessels. Researchers have identified several factors associated with their development.

Age: Hemangiomas are most common in newborns and infants. They typically appear between 2 weeks and 2 months of age.

Prematurity and Low Birth Weight: Up to 1 in 5 premature babies develop hemangiomas. Babies born with low birth weight also have increased risk.

Sex: Infantile hemangiomas occur up to 4 times more frequently in females than males. The reason for this gender difference isn’t fully understood.

Skin Color: Hemangiomas are more common in babies with lighter skin.

Genetic Conditions: Certain genetic syndromes increase risk. PHACE syndrome involves large hemangiomas associated with brain malformations, abnormal arteries, and heart problems. Von Hippel-Lindau disease also increases hemangioma risk.

Can You Prevent Hemangiomas?

There’s no proven way to prevent hemangiomas since their exact cause is unknown. They’re not caused by anything parents did or didn’t do during pregnancy.

However, early evaluation and monitoring can help prevent complications:

Seek Early Evaluation: If your baby develops a hemangioma, have it evaluated early so a baseline is established. This helps your dermatologist track growth patterns.

Monitor for Changes: Watch for rapid growth, ulceration, bleeding, or interference with bodily functions. Early intervention can prevent complications.

Follow Treatment Plans: If treatment is recommended, following your dermatologist’s guidance helps achieve the best outcomes during the growth phase.

Diagnosis and Evaluation

Evaluation by a dermatologist is essential for proper management of hemangiomas. While most are harmless, their location, size, and growth rate determine whether intervention is needed.

During an appointment, your dermatologist uses a systematic approach to confirm the diagnosis and develop an appropriate care plan.

Physical Examination: Hemangiomas are often visible during routine physical exams. Your dermatologist will assess the size, location, depth, and characteristics of the growth.

Medical History: Your dermatologist will ask when the hemangioma appeared, how quickly it’s grown, and whether it causes any symptoms. Family history and pregnancy details may also be relevant.

Ultrasound: Ultrasound is the primary imaging method for hemangiomas because it effectively visualizes blood flow. It helps confirm the diagnosis and assess the extent of deeper components.

MRI: When a hemangioma is large, in a concerning location, or associated with other findings, MRI may be ordered to check for potential risks not visible externally. This is particularly important for evaluating PHACE syndrome.

Biopsy: Tissue testing isn’t always necessary but may be performed when the diagnosis is uncertain or to rule out other conditions.

Blood Tests: May help assess complications from large or multiple hemangiomas, such as effects on liver function or clotting factors.

When Should You Get a Hemangioma Evaluated?

You should see a dermatologist if:

• Your baby develops a red birthmark that’s growing
• A hemangioma is located near the eyes, nose, mouth, or throat
• The hemangioma bleeds, ulcerates, or appears infected
• Multiple hemangiomas are present
• The growth interferes with normal function or development
• You have concerns about appearance or future scarring

Early evaluation allows for timely intervention if treatment is needed during the growth phase.

Hemangioma Treatment Options

Many infantile hemangiomas don’t require treatment and resolve naturally. The decision to treat depends on location, size, growth rate, and risk of complications.

When treatment is appropriate, several effective options exist.

Observation and Monitoring

For small hemangiomas in non-critical locations that aren’t growing rapidly, observation is often the best approach. Your dermatologist will monitor the hemangioma during the first year with frequent visits, then less often as it enters the involution phase.

This conservative approach avoids unnecessary treatment while ensuring complications are caught early.

Oral Beta-Blockers (Propranolol)

Propranolol is an FDA-approved beta-blocker that’s proven to shrink hemangiomas. It’s the first-line medication for hemangiomas requiring treatment.

Propranolol works by reducing blood flow to the hemangioma, causing it to shrink during the proliferation phase. It’s given orally, typically starting when the baby is several weeks to months old. Treatment continues for several months to over a year depending on response.

Side effects are generally mild but may include sleep disturbances, gastrointestinal upset, or changes in blood pressure and heart rate. Regular monitoring ensures safe use.

Topical Beta-Blockers (Timolol)

Timolol is a beta-blocker eye drop that can be applied directly to smaller, thin hemangiomas. It’s an option for superficial hemangiomas that don’t require systemic medication.

Corticosteroids

Corticosteroids applied topically or injected into the hemangioma can cause it to shrink. They’re used less frequently now that propranolol is available but remain an option in certain situations.

Laser Therapy

Laser treatment can stop superficial hemangiomas from growing, shrink them, or reduce discoloration left after involution. Pulsed dye laser is most commonly used for vascular lesions.

Laser therapy works best for superficial components and may be combined with medication for mixed hemangiomas. It’s also useful for treating residual redness after the hemangioma has involuted.

Surgical Removal

Surgery is less common now due to effective medications but may be recommended for:

• Hemangiomas that don’t respond to medication
• Lesions causing severe complications
• Residual scarring or tissue changes after involution

Most surgical procedures for hemangiomas are performed as outpatient surgeries, often before school age.

Sclerotherapy and Embolization

These procedures cut off blood supply to the hemangioma. They’re used less frequently for infantile hemangiomas but may be appropriate for certain cases.

Will Hemangiomas Leave Scars?

About half of children are left with some residual changes after involution—scar tissue, extra blood vessels, or skin discoloration. Early treatment with propranolol during the growth phase may reduce these residual changes. Laser therapy or surgery can address cosmetic concerns after involution.

Why Choose Connolly Dermatology for Hemangioma Treatment

Care Guided by Experience and Clinical Judgment

When a vascular birthmark raises concern, families want careful evaluation and clear guidance. Connolly Dermatology provides expert, physician-led care for patients with hemangiomas, with an emphasis on accurate diagnosis and appropriate intervention.

Board-Certified Dermatologists

Our dermatologists are experienced in diagnosing and managing vascular birthmarks and benign growths. Decisions about your care follow current clinical guidelines and reflect evidence-based dermatology.

Comprehensive Evaluation

We perform thorough physical examinations and utilize imaging when appropriate to fully assess hemangiomas. This comprehensive approach ensures we identify complications early and develop effective treatment plans.

Multiple Treatment Options

We offer observation, medication management, laser therapy, and surgical referrals when needed. Your dermatologist will recommend the approach that best fits your situation based on the hemangioma’s characteristics and your preferences.

Coordination with Specialists

For complex cases involving critical locations or associated syndromes, we coordinate with pediatricians, ophthalmologists, and other specialists to ensure comprehensive care.

Family-Centered Care

We understand that seeing a birthmark on your baby can be concerning. We take time to explain what you’re seeing, what to expect, and why we’re recommending a particular approach. You’ll never feel rushed or dismissed.

Comfortable, Compassionate Care

Our team focuses on clear explanations, thoughtful communication, and minimizing discomfort during evaluations and procedures. We want you and your child to feel comfortable and confident in our care.

What To Expect During Treatment

Guiding You Through Evaluation and the Next Steps

Many families feel apprehensive when their baby develops a hemangioma. At Connolly Dermatology, we guide you through the evaluation and treatment process so you know what to expect at every step.

Before Your Appointment

Preparing in advance helps your dermatologist understand the whole picture. Note when the hemangioma first appeared and how it has changed. Take photographs showing its growth if possible. Bring a list of medications and relevant medical history, particularly about prematurity or genetic conditions.

During the Evaluation

During your visit, your dermatologist will review your medical history and then perform a focused examination. They’ll assess the hemangioma’s size, depth, location, and characteristics. They’ll explain what they’re seeing in plain language.

If the hemangioma is small, in a non-critical location, and growing slowly, observation may be recommended. If it’s large, growing rapidly, or in a concerning location, treatment options will be discussed.

Your dermatologist will take time to answer your questions and address your concerns. You’ll leave with a clear understanding of the plan moving forward.

During Treatment

If medication is prescribed, you’ll receive detailed instructions on administration, dosing, and monitoring. For propranolol, initial doses may be given in the office with monitoring before continuing at home.

If laser therapy or procedures are recommended, your dermatologist will explain what to expect, how to prepare, and how to care for the area afterward.

Follow-Up Care

Regular follow-up visits track the hemangioma’s response to treatment and identify any complications early. During the first year, visits may be frequent. As the hemangioma enters involution, visits become less frequent.

You’ll be encouraged to contact us between visits if you notice concerning changes.

Get Clear Answers from Connolly Dermatology

Make Informed Decisions About Your Skin Health

Hemangiomas are benign vascular growths that form when blood vessels cluster incorrectly. Most are harmless and fade on their own over several years. However, some require treatment to prevent complications or address cosmetic concerns.

If you or your child has a hemangioma that concerns you, a professional evaluation provides clarity and peace of mind. At Connolly Dermatology, our board-certified dermatologists offer expert assessment and personalized care for patients with hemangiomas.

Schedule a visit with a dermatologist to get clear, informed guidance about your skin.