Infantile haemangiomas Factsheet
Introduction
Infantile Haemangiomas are common birthmarks that appear shortly after birth. They are sometimes called haemangiomas of infancy or 'strawberry birthmarks' due to their red, purple, and blue colour.
Infantile haemangiomas can happen when there is an overgrowth of cells that line the blood vessels. Doctors are unsure why this happens, but some factors increase the likelihood.
Risk factors can include:
- being female
- being born in the breech position – when a baby is born bottom first
- having a low birth weight
- being born prematurely, before 36 weeks of pregnancy
- multiple births – being a twin or triplet
- being born to a mother who is over 35 years old.
Infantile Haemangiomas can occur anywhere on or inside the body but are more common on the head and neck areas.
Most infantile haemangiomas do not need any treatment but may need to be checked by a doctor if they are large, causing issues or growing in or around places like the:
- eyes
- throat
- nose.
Signs and symptoms
An infantile haemangioma can look like a scratch or small bruise before it grows rapidly during the first few months of a baby’s life.
As they grow, they can look like:
- red patches with visible blood vessels
- blue lumps under the skin
- a combination of both.
While most infantile haemangiomas will usually shrink and fade away by the time your child is five years old, some may last up until age nine.
Some will disappear completely, while others may leave scars or loose skin.
Diagnosis
See your local doctor or child and family health nurse if you think your child has an infantile haemangioma. Early treatment during the first three months of your baby’s life is important as the infantile haemangioma will grow rapidly during this time.
A simple infantile haemangioma can be diagnosed and managed by your local doctor. More complex infantile haemangiomas are diagnosed and treated by a skin specialist called a dermatologist.
Your local doctor should refer you to a dermatologist for any of the following:
Size, location, and impact on body functions
Infantile haemangiomas can cause issues with important body functions like breathing, hearing, vision and feeding when they press on important areas like the:
- eyes
- nose
- ears
- windpipe.
Infantile haemangiomas that are large and on the face, especially around the eyelids, need urgent treatment to prevent severe complications like blindness.
Some infantile haemangiomas can also be large and affect a child’s appearance.
Ulceration and Bleeding
Ulceration is when the skin breaks down, causing an open wound. Ulceration often happens in areas where there is pressure and rubbing on the skin, including:
- folds of the neck
- armpits
- skin covered by a nappy.
See your local doctor as soon as possible if your child’s haemangioma is:
- ulcerated
- bleeding
- feeling tight
- shiny looking
- painful.
Multiple haemangiomas
Babies with more than five visible haemangiomas may need to be checked for haemangiomas inside the body.
Unclear about the diagnosis
Some other conditions can be confused with infantile haemangiomas. Your child’s dermatologist will be able to investigate any concerns.
Treatment
Most infantile haemangiomas do not cause problems and will go away on their own over time.
Parents and carers should check them regularly for any changes.
Your child’s doctor will speak to you about the most suitable treatment option and any other tests or checks that should be done before starting.
Beta-blockers
If treatment is necessary, your child’s dermatologist may prescribe a medication known as a beta-blocker. Beta-blockers are safe and have been proven to work effectively.
- Oral Beta-Blockers:
Oral beta-blockers are medicines that are given by mouth. They work by limiting blood flow to the growth, preventing it from getting bigger. Oral beta-blockers are usually taken until your child is 12 months old.
- Topical Beta-Blockers:
Topical beta-blockers are medicines that are applied to infantile haemangiomas on the skin. They are commonly used on flat, simple growths to help improve the colour faster.
Other treatment options
Other treatment options are only used in rare cases.
These include:
- corticosteroids – medicines that stop inflammation
- laser therapy – used for younger children to reduce redness and the appearance of broken blood vessels
- surgery – to correct scarring or loose skin after a haemangioma has gone away.
Management
Other types of birthmarks
Some other types of birthmarks can include:
- congenital haemangiomas: haemangiomas that are fully formed at birth when your child is born
- vascular malformations: abnormal growth of blood vessels that grow large and do not go away.