What is a Hemangioma?
A hemangioma is a benign (noncancerous) lesion made up of clusters blood vessels. It occurs when small blood vessels begin to multiply at an abnormal rate forming an elevated lump. Most hemangiomas occur on the surface of the skin or just beneath it. They often develop on the face and neck, and can vary greatly in color, shape, and size.
There are several different categories of hemangiomas. Some appears in infancy and are considered to be birthmarks, while others appear in adulthood. The four most common types we come in contact with are:
1 – Infantile Hemangioma
Infantile Hemangioma is a common type of birthmark found in infants. It occurs in approximately 7-10% of the population and statistically occur more frequently in girls. At times they are present right at birth, but more often they appear gradually over the first few weeks or months of life. Over the first year of life, there is a period of rapid growth followed by a static period where there is minimal or no change. Around the first year of life, these hemangiomas will start to involute, where the body naturally shrinks the blood vessels and the lesion resolves spontaneously. The majority of infantile hemangiomas have completely resolved by the age of 7. In most cases, we will simply monitor hemangiomas closely and allow them to involute naturally. However, in some cases we will initiate treatment with vascular lasers, especially is the hemangioma is prone to ulceration and bleeding. Rapidly proliferating large hemangiomas are now most commonly treated with systemic beta blockers.
2 – Port Wine Stain (PWS)
A Port Wine Stain (PWS) is permanent birthmark that usually presents as a large flat patch of purple or dark red skin with well-defined borders right at birth. Generally, they appear on one side of the body, with the majority of lesions occurring on the face. Unlike infantile hemangiomas, port wine stains will NOT regress and fade spontaneously. Conversely, they can become darker and develop a bumpy surface with vascular blebs (bumps) overtime. In addition, when PWS are located around the eye, they can be associated with Sturge-Weber syndrome, which requires further medical evaluation.
The physical changes and a port-wine stain’s cosmetic appearance can cause both medical problems and emotional stress for both the patient and their family. Therefore, early treatment is recommended. Not only is it recommended to improve the cosmetic appearance, but more importantly to prevent further medical complications in the future such as vascular nodules.
3 – Capillary Hemangioma (CH)
Capillary Hemangioma (CH) is the most common type of hemangioma that develops in adulthood. It is made up of small capillaries that are normal in size and diameter, but increased in number. These capillaries form a tightly packed group held together by thin connective tissue. Because of their proximity to the surface of the skin, capillary hemangiomas are typically brighter red in color, but they can also become dark red or purple. They can be small or large, and may be flat to the skin, raised, or protrude out as a nodule. These have no cancerous potential, but will not resolve without treatment so they can be treated for cosmetic purposes. Smaller, flatter lesions can effectively be treated with the V Beam pulsed-dye laser and larger lesions can be removed with Ultrapulse Co2 laser.
4 – Pyogenic Granulomas (PG)
Pyogenic Granulomas (PG) are a type of lobular capillary hemangioma. These small, red bumps often appear spontaneously on the hands, face, arms or other parts of the body. Because they contain so many blood vessels, they bleed easily – often with just minor contact. This type of hemangioma is also sometimes referred to as a “pregnancy tumor” because they frequently appear during pregnancy. Although these have no cancerous potential, they usually do not resolve spontaneously. They can be removed effectively with one session using the Ultrapulse Co2 laser.