What should I do if my baby has a hemangioma?

Currently, most patients suffering from hemangioma are babies, especially newborns, where the disease is a common phenomenon. Hemangiomas are generally benign tumors, but sometimes they are vascular malformations. Hemangiomas generally appear as white, purple, or bluish-purple skin spots on the skin surface. Sometimes hemangiomas protrude from the surface of the skin. Patients with hemangiomas need to be observed and treated.

Most pediatric hemangiomas can resolve on their own, so most do not require treatment in infancy and childhood. However, most parents are eager for treatment, so it is necessary to explain to their children that hemangiomas that resolve on their own often do not leave scars. On the contrary, improper treatment, such as freezing, laser, sclerosing agent injection, etc., can cause scars. On the other hand, close follow-up should be carried out to deal with possible complications such as ulcers and bleeding at any time.

However, a few hemangiomas may cause some problems, even life-threatening, and need timely treatment: 1. Large ulcers may cause repeated infection and bleeding; 2. Rapidly growing hemangiomas on the head and face may seriously affect the appearance; 3. Hemangiomas located on the upper eyelid should be treated early, because even small tumors on the upper eyelid can cause corneal deformation and refractive amblyopia, and tumor growth that obscures the line of sight can cause disuse amblyopia; 4. Hemangiomas on the head and face compress or block life-critical structures or ducts, such as subglottic hemangiomas; 5. Life-threatening complications may occur, such as congestive heart failure and massive gastrointestinal bleeding.

The current main drug treatment is glucocorticoids, which can be used systemically or locally with roughly the same efficacy. Common systemic medications include 2-3 mg/kg of prednisone, taken orally once a day in the morning for 2-3 weeks. In sensitive cases, the lesions may soften in about 7 days, and a change in color from purple or dark red to dark purple is the first sign that treatment is effective. If it is effective, the medication can be used continuously for 4 to 6 weeks, and then gradually reduced to maintain the effect. During the maintenance period, the medication can be taken every other day to reduce side effects. The whole course of treatment is 3 months. Surgical treatment is suitable for patients who are ineffective with drug treatment and/or have one of the following conditions: 1. Patients with persistent ulcers or bleeding, especially pedunculated lesions; 2. Lesions that threaten life or vital organ function, such as upper eyelid hemangioma; 3. Lesions that seriously affect appearance and cause psychological burden to children, or those that have not disappeared before school age, such as nasal and lip lesions, which are best removed in stages from 3 to 4 years old; 4. Patients with incomplete disappearance or skin and soft tissue hyperplasia; 5. Deep hemangiomas with complications. The biggest risk of surgical resection is massive bleeding. Therefore, a variety of hemostatic methods should be prepared before surgery. Tourniquets can be considered for hemangiomas in the limbs, and sufficient blood must be prepared. Angiography should be performed before surgery for giant hemangiomas to clarify the nutrient branches of the hemangiomas and facilitate surgery. The surgery should fully expose the surroundings of the hemangioma so that it is easier to control the main blood vessels entering the hemangioma. Sometimes buried ligation is required around the tumor. The surgery aims to completely remove the hemangioma in one stage, as the residual hemangioma may easily induce coagulation disorder and cause disseminated intravascular coagulation.

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