SERVICES
Paediatric haemangiomas

OVERVIEW

Haemangiomas are abnormal formations of blood vessels that multiply excessively during early infancy. They typically appear as marks or coloured patches on the skin at birth or shortly after birth. During the first five months of a baby's life, these haemangiomas undergo rapid growth, reaching about 80 per cent of their maximum size by around three months of age.

However, most of them stop growing and begin to shrink by the baby's first birthday, gradually flattening and becoming less red over time. This phase, known as involution, continues from late infancy to early childhood. While nearly half of the affected children may have residual scar tissue or extra blood vessels on the skin, infantile haemangiomas are the most common tumours in babies, more frequently occurring in girls and Caucasian children. Premature birth or low birth weight can increase the likelihood of developing an infantile haemangioma.

Types of haemangiomas

Haemangiomas can manifest anywhere on the body, and some children may develop multiple ones. There are three primary types of haemangiomas:

Superficial haemangiomas: Initially appearing flat, these haemangiomas gradually become bright red and acquire a raised and uneven surface.
Deep haemangiomas: These haemangiomas present as bluish-purple swellings beneath the skin, featuring a smooth surface.
Mixed haemangiomas: This type combines both superficial and deep components, exhibiting characteristics of both types within a single haemangioma.

Symptoms of haemangiomas

Haemangiomas typically appear in early infancy and can be mistaken for birth-related scratches or bruises. They initially present as flat, red patches with visible blood vessels. Haemangiomas can resemble a strawberry on the skin’s surface or appear as bluish lumps if they are deeper in the skin. Some haemangiomas have both surface and deep components. While they can also develop internally, they usually do not cause problems. Haemangiomas grow rapidly in the first months but generally stop by the child's first birthday. Afterwards, they begin to shrink and fade. While some completely disappear, others may leave behind loose skin, and their duration varies.

Treatment

Most haemangiomas resolve on their own without requiring treatment. However, if a haemangioma causes problems, there are various treatment options available. Your child's doctor will discuss the most suitable choice based on factors such as the size, location, and behaviour of the haemangioma. Treatment options may include:

Topical medication: These are applied directly to the skin and can include topical beta blockers, which help lighten the haemangioma and slow its growth, particularly for smaller, superficial haemangiomas. Topical antibiotics may also be used if there are open sores with a risk of infection.
Oral medication: Taken by mouth, oral medicine requires close monitoring for potential side effects. Propranolol is now considered the primary treatment for concerning haemangiomas, while prednisone is used in select cases that may not respond to other treatments or when propranolol is not suitable.
Surgery: Surgical removal of the haemangioma may be considered once it has stopped growing or if other treatments have been unsuccessful. Surgery can also be performed to address residual markings left by the haemangioma.
Laser treatment: Laser therapy can help lighten the appearance of blood vessels remaining after the haemangioma has been resolved.

REQUEST A CONSULTATION

Dr Mangray, the founder of KZN Specialised Paediatric Surgical Service, and his associates, Dr Ngobese, Dr Govender and Dr Dube-Zvirikuzhe, have a well-established reputation for caring for children right until late adolescence.

FREQUENTLY ASKED QUESTIONS

FAQ

1What factors determine the need for treatment?

Haemangioma treatment depends on its size, location, and behaviour. If a haemangioma is causing discomfort, interfering with vital functions, or affecting appearance, treatment options may be considered.

2What are the risks associated with oral medication for haemangiomas?

Oral medications, like propranolol, may have side effects and require close monitoring. Prior to starting oral medication, tests may be conducted to ensure the child's safety and determine the appropriateness of the treatment.

3What should I discuss with my child's doctor when considering treatment options?

It is essential to have a conversation with your child's doctor to understand the specific characteristics of the haemangioma, evaluate the risks and benefits of each treatment option, and determine the most suitable course of action for your child's condition.