Hemangioma

Overview

What is a hemangioma?

Hemangiomas are a type of growth that appear as red or purple lumps on your skin. They’re made of rapidly dividing cells of blood vessel walls (endothelial cells). They may be present at birth, or become noticeable during infancy. Although hemangiomas are most common in infants and children, adults can develop them too. In fact, about 75% of people aged 75 and older have cherry hemangiomas.

What is the difference between a hemangioma and a birthmark?

Hemangiomas are a type of birthmark. There are two types of birthmarks: red and pigmented. Hemangiomas are red birthmarks that are vascular (originating from blood vessels).

Is a hemangioma a tumor?

Yes, but not all tumors are cancer. A tumor is a growth of tissue that's swollen and can appear as a bump on your body. Non-cancerous tumors don’t spread to other parts of your body and aren’t life-threatening. Hemangiomas are a common, non-cancerous tumor that can be removed without the risk of coming back after surgery.

What are the types of hemangiomas?

The two most common types of hemangiomas are:

Capillary

Capillary hemangiomas appear on the outer layers of your skin.

  • Infantile hemangioma (strawberry hemangioma): These blood vessel growths are common tumors of infancy, affecting up to 12% of babies by their first year. Infancy hemangiomas look like red bulges on the skin that normally grow to between one-quarter to 2 inches in size. Infancy hemangiomas typically grow quickly, and then shrink and fade.
  • Cherry hemangiomas: Cherry hemangiomas are small, dot-like, raised red blood vessel growths often found on your torso. They're very common in adults, especially as they age. Cherry hemangiomas usually form in groups of a few to dozens.

Cavernous

Cavernous hemangiomas form in deeper layers of your skin, often around your eye.

  • Cavernous hemangiomas often appear on eyelids, the eye surface or in the eye socket. They look like clusters of wide blood vessels that are dark red to blue when they first appear on or under your skin.
  • These hemangiomas can affect eye development and lead to vision problems like amblyopia, glaucoma and cataracts.

Who do hemangiomas affect?

Anyone can get a hemangioma at any point in their lifetime. They're common in:

  • Infants.
  • People assigned female at birth (they're more likely to have hemangiomas than people assigned male at birth).
  • White infants (they are at higher risk).
  • Premature infants.
  • Middle-aged adults.

How common are hemangiomas?

Around 10% of babies are born with a hemangioma.

Is a hemangioma life-threatening?

Hemangiomas slowly disappear over time. The majority aren't life-threatening.

Symptoms and Causes

What causes hemangiomas?

Hemangiomas are caused by blood vessels that don’t form properly. The direct cause is unknown. In children, hemangiomas are caused by blood vessels that don’t develop correctly during pregnancy. Though some hemangiomas develop in adults after an injury or illness, researchers haven’t established what causes hemangiomas.

Where do hemangiomas grow?

Hemangiomas grow on or within your skin. They can form anywhere on your body, with more than half growing on your head and neck. Sometimes, hemangiomas can be found on organs like your liver.

What does a hemangioma look like?

A hemangioma looks like:

  • A bulge on the skin.
  • Bright red to purple.
  • Between one-quarter to 2 inches in size.

Do hemangiomas bleed?

Hemangiomas located near your mouth — or the diaper area in infants — commonly bleed due to friction. If these locations become red, change color or become ulcerated (turn into an open wound), it could be a sign of infection.

Do hemangiomas hurt?

Most hemangiomas don’t hurt. Since hemangiomas stand out on your skin, they can be easily injured if bumped or scraped. In the case of an injury to your hemangioma, you should treat it like any other wound with hygienic cleaning, applying antibacterial ointment and covering it with a bandage.

Cavernous hemangiomas may cause pain depending on their location, especially if they’re found on muscles or in bones.

How long will a hemangioma stay on the skin?

Hemangiomas begin shrinking in size when a baby is 12 to 18 months old and often disappear by age 10.

Diagnosis and Tests

How is a hemangioma diagnosed?

Capillary hemangiomas are diagnosed by a visual examination by a healthcare provider. Some hemangiomas on the organs can be diagnosed during an imaging test, like an ultrasound.

Management and Treatment

How are hemangiomas treated?

For most hemangiomas that aren’t obstructing vision near your eyes, treatment isn't necessary. They tend to disappear on their own over time. Hemangiomas that are located near your eyes may lead to vision problems if left unchecked.

In some cases, a doctor may prescribe medication — a beta blocker like oral propranolol or timolol gel, or a steroid — to shrink the blood vessels and reduce the appearance of the hemangioma.

Can hemangiomas be removed?

Yes. If a hemangioma is bothersome to you, a surgeon can remove it. This is common practice with cherry hemangiomas. Although many hemangiomas don't cause harm, people often opt to have them removed because they don’t like how they look.

Laser treatment can sometimes reduce the size or stop the growth of hemangiomas.

What is hemangioma involution?

Involution is when your hemangioma shrinks in size and often disappears. Nearly half of all hemangiomas in infants gradually disappear by age 5 and 90% disappear by age 10.

Prevention

How can I prevent a hemangioma?

There's currently no way to prevent hemangiomas.

Is my child’s hemangioma a result of something I did during pregnancy?

No, hemangiomas in infants aren't caused by ignoring cravings, specific foods, activities, medication or exposure to chemicals during pregnancy. Rest assured: most hemangiomas cause no harm and disappear over time.

Outlook / Prognosis

What can I expect if I have a hemangioma?

Since most hemangiomas go away on their own, doctors may not treat them when they first appear, unless they grow quickly, block vision, block airways or turn into wounds (ulcerate). In the case of severe hemangiomas that could cause problems with your child’s development, a doctor may recommend treatment.

Living With

When should I see my healthcare provider about my hemangioma?

Contact your healthcare provider if the hemangioma:

  • Changes color.
  • Starts bleeding.
  • Blocks your vision.
  • Blocks your ability to breathe or eat.

What questions should I ask my provider about my hemangioma?

  • Will the location of this hemangioma affect my vision?
  • How should I care for an open wound (ulcerated) hemangioma to prevent infection?
  • Will this hemangioma result in scarring?

A note from Cleveland Clinic

The majority of hemangiomas are harmless. The good news is that the best treatment for hemangiomas is time. Over time, your hemangioma should disappear on its own. Watch for potential warning signs of an unusual hemangioma, like color changes, bleeding, vision changes, or difficulty eating or breathing. Contact your healthcare provider if you notice these or other sudden changes to your hemangioma.

Last reviewed by a Cleveland Clinic medical professional on 06/28/2022.

References

  • American Academy of Dermatology Association (AAD). Birthmarks: Overview. (https://www.aad.org/public/diseases/a-z/birthmarks-overview) Accessed 6/28/2022.
  • American Academy of Ophthalmology. What Is Hemangioma. (https://www.aao.org/eye-health/diseases/hemangioma) Accessed 6/28/2022.
  • American Academy of Orthopaedic Surgeons. Hemangioma. (https://orthoinfo.aaos.org/en/diseases--conditions/hemangioma) Accessed 6/28/2022.
  • Merck Manual. Hemangiomas. (https://www.merckmanuals.com/home/skin-disorders/noncancerous-skin-growths/hemangiomas?query=hemangioma) Accessed 6/28/2022.
  • StatPearls. Cherry Hemangioma. (https://www.ncbi.nlm.nih.gov/books/NBK563207/) Accessed 6/28/2022.

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