Strawberry Hemangiomas

What is a strawberry hemangioma?

A strawberry hemangioma is a clump of tiny blood vessels that forms under the skin. It causes a raised red skin growth that may be present at birth or develop during infancy. A hemangioma looks like a strawberry birthmark, but it’s actually a benign (noncancerous) tumor. You may also hear the term vascular birthmark.

The tumor often grows for the first year and then shrinks, usually without treatment. About 10% disappear by the child’s first birthday. Of the rest, 90% of hemangiomas fade away by a child’s 10th birthday.

Hemangiomas are most common in children. They are not usually visible at birth. Instead, they usually show up during the first few days or months of life. They can appear on any part of the body, but they are most common on the head or face. When they first show up, they can grow very quickly. Later on, they usually shrink and eventually disappear.

How common are strawberry hemangiomas?

Infantile hemangiomas are the most common vascular tumors. As many as 1 in 10 babies develop a hemangioma. Some children have more than one hemangioma.

What are the types of hemangiomas?

There are different types of hemangiomas, including:

• Superficial (capillary) hemangiomas form just underneath the top layer of skin (the epidermis). Strawberry hemangiomas are a type of superficial hemangioma.
• Cavernous hemangiomas go deeper into the skin’s bottom fatty layer (hypodermis). The skin may bulge and have a blue or purple tint. A deep hemangioma can be painful and prone to bleeding.
• Mixed hemangiomas have the strawberry look as well as a skin bulge.

Can adults get strawberry hemangiomas?

Hemangiomas can form during adulthood. In adults, this benign growth of blood vessels is a cherry angioma.

The round, cherry-red spots may be smooth or raised. They typically appear on a person’s trunk after age 30. Around 3 in 4 people over age 75 have them. Because they’re so common with aging, they’re also called senile angiomas.

Cherry angiomas don’t go away. In fact, you’ll probably get more of them as you age. If their appearance bothers you, a dermatologist (skin specialist) can remove them.

What causes strawberry hemangiomas?

Experts aren’t sure why some babies get hemangiomas. They’re not the result of anything a person does during pregnancy. It’s a myth that foods or stress cause any type of birthmark.

Strawberry hemangiomas form when blood vessels and cells close to the skin don’t develop as they should. Instead, the vessels clump together into a noncancerous mass or tumor.

What are the risk factors for strawberry hemangiomas?

Any child can have a strawberry hemangioma, but these factors may increase the risk:

• Female sex. Hemangiomas are two to three times more common among females than males.
• Low birth weight (less than 5^½ pounds).
• Multiple birth (twins, triplets or more).
• Premature birth (before the 37^th week of pregnancy).
• White race.

What are the stages of strawberry hemangiomas?

Most strawberry hemangiomas appear within an infant’s first month. Some are present at birth, while others appear during childhood. You may notice a tiny scratch or bump. This mark grows bigger during an infant’s first 4 to 6 months of life.

After the tumor stops growing (typically before age 1), it gradually shrinks. It may turn gray or white. Some children have pain as the hemangioma shrinks. Most hemangiomas fade by the time a child is 10.

What are the symptoms of strawberry hemangiomas?

Strawberry hemangiomas get their name because of their strawberry-red color and appearance. But some hemangiomas are more purple or brown (like a bruise), especially on darker skin.

The raised lump may have a firm, rubbery feel. Hemangiomas aren’t itchy or painful.

Strawberry hemangiomas commonly appear on the face and neck, but they can be on any part of the body. Some children have hemangiomas inside their mouths or anus.

How are strawberry hemangiomas diagnosed?

A healthcare provider can diagnose a strawberry hemangioma based on appearance. Your child shouldn’t need any tests.

How are strawberry hemangiomas treated?

Many children with strawberry hemangiomas don’t need treatment. Your healthcare provider may recommend early treatment if the hemangioma:

• Affects vision, hearing, breathing, eating or other body functions.
• Grows rapidly or is large.
• Significantly affects appearance or self-esteem.

Hemangioma treatments include:

• Beta blockers (oral-propranolol) or topical- timolol.
• Laser treatments.
• Surgical removal.

What are the complications of strawberry hemangiomas?

Most strawberry hemangiomas are harmless. But some hemangiomas do cause problems if they:

• Form near the eye: These hemangiomas may spread into the eye socket and press on the eye, affecting vision. They raise the risk of problems like glaucoma or lazy eye (amblyopia).
• Form inside the mouth: Strawberry hemangiomas in or near the mouth can spread into the airways, interfering with breathing and eating. Medications can shrink these tumors.
• Are fragile: The skin on a hemangioma may break open easily when bumped. These wounds often take longer to heal, which increases the risk of infection.
• Affect self-esteem: A hemangioma on the face may affect a child’s self-confidence, especially if peers tease them. Your child may struggle in school or exhibit behavioral or personality changes. They may become depressed or anxious. Counseling can help your child foster a positive self-image.

What’s the prognosis for someone with strawberry hemangiomas?

Most strawberry hemangiomas disappear by age 10. After the tumor goes away, a child may have slight skin discoloration, skin puckering or a barely noticeable scar.

In some cases, a large hemangioma that shrinks on its own may leave sagging skin. A surgical procedure can remove the excess skin.

When should I call my doctor?

You should call your healthcare provider if your child has:

• Hemangioma near the eyes or mouth.
• Multiple hemangiomas, especially in “midline.”
• Nonhealing wound.
• Signs of infection like redness, warmth, swelling or discharge at the site of the hemangioma.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

• Do you recommend treating the strawberry hemangioma or waiting for it to fade?
• If we choose to treat the hemangioma, what is the best treatment for my child?
• What are the potential side effects or risks of treatment?
• Should I look out for signs of complications?

A note from Cleveland Clinic

Strawberry hemangiomas are common among children and aren’t harmful. These noncancerous tumors eventually fade, usually without treatment. If your child has a sizable hemangioma that affects appearance and self-esteem, your healthcare provider may recommend treatment. Medicines can shrink the tumor, making it less noticeable. Providers often treat hemangiomas that grow close to the eye or mouth to prevent vision and breathing problems. By the time you celebrate your child’s 10th birthday, the hemangioma should be a memory.