Treatment & Care
Finding out that your child has a hemangioma can be upsetting. But you can rest assured that your child is in good hands here at Children’s Hospital Boston. Our physicians are bright, compassionate and committed to focusing on the whole child, not just his or her condition — that’s one reason we’re frequently ranked as a top pediatric hospital in the United States.
And should your child’s hemangioma need treatment, Children’s is home to the world’s first and largest Vascular Anomalies Center — which means we’ve got the expertise and experience to make sure your baby returns to good health as quickly as possible.
How are hemangiomas treated?
Most hemangiomas don't require any treatment (other than observation) because they go away on their own.
In some children, loose skin, discoloration or tiny, dilated blood vessels may remain after the hemangioma has shrunk. When this occurs, an operation or laser therapy can improve your child's appearance; often treatment is done before your child starts school.
How do I care for my child’s hemangioma at home?
While most hemangiomas don’t require formal treatment, there are some things you can do. Because the skin is stretching during the growth phase of the hemangioma, the lesion can be prone to ulceration and bleeding.
- Keep your child’s skin around the lesion moist with a hydrated petroleum gel.
- If your child’s lesion does begin to bleed, wash the wound gently twice a day with soap and water.
- You can also apply a topical antibiotic to reduce the risk of infection.
If the affected area is large, you’ll need to dress your baby’s wound several times a day.
Although an ulcerated lesion may look unsightly and be painful for your baby, remember that it will eventually heal – most within two weeks.
Are there hemangiomas that require treatment from a doctor?
Yes. If your child’s hemangioma is obstructing vital functions like breathing or vision, your doctor will treat it. We’ll also treat a hemangioma if the skin around it begins to bleed (or gets infected), or if the lesion distorts your child’s facial features. We use medications and surgical procedures to treat these kinds of hemangiomas.
Researchers from Children’s have found that steroids can act on hemangioma stem cells, interfering with their ability to stimulate new blood vessel growth, which allows the hemangiomas to grow.
- If your child has a small hemangioma near his nose or eye — or if the hemangioma threatens important facial structures like the eyelid or lip — your doctor will probably recommend an injection of a corticosteroid into the lesion.
- If the problematic hemangioma is larger, your doctor will likely recommend that your child take an oral steroid called prednisolone every day until the tumor has stopped growing (when your child is 10 to 12 months old).
We’ve been using corticosteroids to treat hemangiomas for more than 40 years — they’re very safe and effective in nearly every child we treat.
You can usually see some or all of the following signs that the hemangioma is responding in less than a week.
- decreased growth rate
- fading color
- softening of the lesion
What about propanolol? Or interferon?
Propanolol is another medication that can potentially be used to treat hemangiomas; however, the effectiveness and risk of this drug is still being studied. At the present time, we feel that steroids are more effective and safer than propanolol.
Interferon has also been used to slow the growth of blood vessels in a hemangioma. However, there is a very real risk of interferon causing neurological problems in children less than one year old, so we no longer use this drug.
While the tumor is growing
We don’t generally recommend surgery for hemangiomas while they are growing rapidly during a child’s first year of life. However, your doctor may want to remove the hemangioma in certain circumstances.
After the tumor has shrunk
Half of hemangiomas leave behind excess skin and tissue after they’ve shrunk, and your doctor may recommend an operation to improve your child’s appearance, and work with you to determine the best time for this operation. Many parents like to do it before their child enters school.
Will my child have a scar?
Every surgical operation results in a scar of some size. However, John B. Mulliken, MD, co-director of the Boston Children’s Hospital’s Vascular Anomalies Center, has developed an innovative way to reduce scars resulting from surgical removals of hemangiomas.
You can find more information about this technique in the Research & Innovation section.
We don’t recommend laser therapy for hemangiomas while your child is an infant. It can cause scarring and does not stop the tumor from growing.
However, pulsed-dye laser therapy is helpful to eliminate excess blood vessels after the tumor has fully shrunk.
In very rare cases, your doctor may recommend embolization, a procedure in which particles are injected into affected blood vessels to stop the blood flow. We may use embolization to treat kids with congestive heart failure from a large hemangioma.
Coping & support
We understand that you may have a lot of questions when your child is diagnosed with a hemangioma. We’ve tried to provide some answers to those questions in these pages, and we also have a number of other resources to help you and your family.
Patient education: From the first office visit, our nurses will be on hand to walk you through your child’s treatment and help answer any questions you may have — Does my child need treatment? What can we expect next? They will also reach out to you by phone, continuing the care and support you received while at Children’s.
Parent to parent: Want to talk with someone whose child has a hemangioma? We can often put you in touch with other families who can share with you their experience.
On our For Patients and Families site, you can read all you need to know about:
- getting to Children’s
- navigating the hospital experience
- resources that are available for your family
And here are a few helpful pages with more information about hemangiomas:
- Our Vascular Anomalies Center has a page with links to organizations that offer support and education for parents who have a child with a vascular anomaly.
- The National Organization of Vascular Anomalies has an informative site.
- You can also find an active, online support group at the web site of the Vascular Birthmarks Foundation.