Vascular Malformations and Hemangiomas

What are hemangiomas and vascular malformations?

Hemangiomas 

Hemangiomas are growths of blood vessels. They’re also called birthmarks. But they often can't be seen at birth. They usually form in the first few weeks of life.

These growths often start as faint red marks. They are the most common type of noncancerous (benign) skin growths. Females are 3 times more likely to get them than males. Hemangiomas are more common in multiple births and low-birth weight premature infants. Most hemangiomas are in the head or neck area, but they can occur anywhere in the skin, mucous membranes, or internal organs. Most will keep growing for the first 3 to 5 months of life. Then they start to shrink. Almost 50% disappear by the age of 5, and the vast majority are gone by age 10. The rate of shrinkage, however, varies. It is also important to know that complete shrinkage does not always result in normal looking skin. Up to 50% of children with hemangiomas have ongoing skin issues such as scarring, skin discoloration, and tissue wasting (atrophy).

Vascular malformations 

Vascular malformations are also growths of blood vessels. They also are noncancerous. They are present at birth. They’re also called birthmarks. But they may not be seen for months or weeks after birth. They grow slowly throughout life. They don’t shrink.

There are 5 types of vascular malformations. They are:

• Port wine stains (red or purple in color)

• Venous malformations

• Lymphatic malformations

• Arteriovenous malformations

• Mixed malformations, a combination of any of the other types

What causes hemangiomas and vascular malformations?

The cause of hemangiomas and vascular malformations often isn’t known. They may be passed on (inherited) in some families.

The way they’re passed on is called autosomal dominant inheritance. This means that only one parent needs to have the gene to pass it on. If the parent has the gene, the family has a 1 in 2 chance that each child will have this condition.

What are the symptoms of hemangiomas and vascular malformations?

Hemangiomas start as faint, red birthmarks. Then they grow very fast. Over time, they become smaller and lighter in color.

Vascular malformations are also birthmarks. They grow much more slowly than hemangiomas. They don’t shrink.

How are hemangiomas and vascular malformations diagnosed?

Your child’s healthcare provider will diagnose your child’s skin growth. The diagnosis will be based on how it looks and if it changes over time. Your child may need to have an ultrasound. This can help the healthcare provider make the diagnosis.

How are hemangiomas and vascular malformations treated?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment for hemangiomas depends on their size, location, and how severe they are. Small hemangiomas often shrink on their own. These usually don’t need treatment.

If your child has a hemangioma near their eyes or airway, it may need to be treated. Your child’s healthcare provider may advise:  

• Steroid medicines

• Injection into the hemangioma (blood vessel embolization)

• Laser or surgical removal

Treatment for vascular malformations depends on the type of malformation. If your child has a large or life-threatening growth, they may need a team of healthcare providers. These can include plastic surgeons, skin care providers (dermatologists), eye care providers (ophthalmologists), and other specialists. Your child may need a combination of treatments. These may include:

• Laser therapy. This is used for port wine stains.

• Injection into the vascular malformation. This is used for arterial malformations.

• Injection of a clotting (sclerosing) medicine. This is used for venous malformations.

What are possible complications of hemangiomas and vascular malformations?

These conditions can be life-threatening if they’re large or affect your child’s airway or another organ. A hemangioma can also be serious if it has uncontrollable bleeding.

Depending on where your child’s growth is located, it may cause physical problems. Your child may have trouble seeing or moving part of their body.

Living with hemangiomas and vascular malformations

Hemangiomas may grow until your child is about 12 months of age. Then they start to shrink. In many cases, they will go away without treatment.

Other hemangiomas need to be treated. These should be treated by a craniofacial healthcare provider. This is a specialist in diagnosing and treating head and face problems. Make sure your child’s provider has experience with hemangiomas.

Vascular malformations don’t shrink or go away without treatment. Your child should see a craniofacial specialist with experience in treating vascular malformations.

Noticeable hemangiomas and vascular malformations can cause psychological and social issues. Support groups can help you, your child, and your family. Ask your child’s healthcare provider about support groups in your area.

When should I call my child's healthcare provider?

Call your child’s healthcare provider right away if your child’s hemangioma or vascular malformation causes issues. These include bleeding or trouble with feeding or breathing. As children age, they may become self-conscious and upset about their condition. Contact your healthcare provider if your child shows signs of anxiety, depression, or social isolation. Ask for professional counseling for your child if the emotional problems are significant.

Key points about hemangiomas and vascular malformations

• Hemangiomas and vascular malformations are noncancerous growths. They show up at birth or soon after birth. They’re also called birthmarks.

• The cause of these growths often isn’t known. They may run in some families.  

• Hemangiomas grow quickly after birth. Then they start to shrink. They may go away without treatment.

• Vascular malformations grow slowly throughout life. They don’t shrink. They usually require treatment.

• Some children with noticeable growths have psychological or social issues. Professional counseling and child-focused support groups can help these children and their families.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your healthcare provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are and when you should report them to your child's healthcare provider.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s healthcare provider after office hours. This is important if your child becomes ill and you have questions or need advice.