It can be a highly alarming moment for a new parent: a few days or weeks after bringing your perfectly healthy baby home from the hospital, you suddenly notice a bright red, rubbery bump rapidly growing on their skin.
Before you panic, take a deep breath. You are likely looking at an Infantile Hemangioma.
A hemangioma is an incredibly common, non-cancerous (benign) tumor made up of an abnormal cluster of extra blood vessels in the skin. Often referred to simply as a birthmark, they appear in about 5% of all infants, most frequently in premature babies or twins. While their rapid growth during the first few months of life can look frightening, the vast majority of hemangiomas are completely harmless and will fade away naturally over time.
However, depending on their size and location, some do require medical intervention. In this comprehensive guide by the Folime pediatric health team, we will help you identify the different types of hemangiomas, understand how they are diagnosed, and explore the available medical treatments.
The 3 Main Types of Infantile Hemangiomas
As a parent, it is incredibly helpful to be able to identify what a hemangioma looks like as soon as it appears. Depending on how deep the blood vessels are clustered, pediatricians classify them into three main types:
1. Superficial Hemangiomas (The «Strawberry Mark»)
This is the most common and recognizable type. Because the clustered blood vessels are right on the surface of the skin, they appear as bright red or pink, raised bumps. Because their slightly bumpy texture resembles the outside of a berry, they are commonly called «strawberry marks.» They are characterized by a rapid increase in size during the baby’s first 3 to 5 months of life.
2. Deep or Subcutaneous Hemangiomas
Unlike the superficial type, deep hemangiomas are located under the top layer of the skin and are therefore more “masked.” Because they are deeper in the tissue, they do not appear bright red; instead, the surface of the skin looks smooth and has a distinct bluish or purple hue. Due to this color, panicked parents often confuse them with severe bruises.
3. Mixed Hemangiomas
As the name suggests, a mixed hemangioma is a combination of the two. It features both a bright red, superficial «strawberry» bump on top, accompanied by a deeper, bluish, swollen base underneath the skin.
(👉 You may be interested in: Skin allergies in children: symptoms, causes, and treatments)
How is an Infantile Hemangioma Diagnosed?
While old wives’ tales used to call these birthmarks «cravings» (based on a myth about what the mother ate during pregnancy), modern medicine knows exactly what they are.
If you notice a rapidly growing mark on your baby, you should point it out to your pediatrician immediately. In almost all cases, a doctor can diagnose an infantile hemangioma simply by performing a physical, visual examination. No painful biopsies or blood tests are required.
During the diagnosis, the pediatrician will closely monitor three things:
- The Position: Location is everything. A hemangioma on the back or leg is usually left alone. However, if it is growing near the eyes (potentially obstructing vision), the mouth (interfering with feeding), or the nose/airway, it requires aggressive monitoring.
- The Size and Growth Rate: Tracking the size gives the doctor an indication of what stage of development the tumor is in (the growth phase or the shrinking phase).
- The Quantity: While most babies only have one, some can develop multiple lesions (multifocal hemangiomas) spread across the body, which may require an ultrasound to ensure none are growing internally on the liver or other organs.
💡 A Tip from the Folime Team:
If you notice a new mark on your baby’s face over the weekend and cannot get an immediate appointment with your pediatrician, do not turn to Google Images, which will only cause you anxiety! Check if your family health insurance policy includes a 24/7 pediatric telemedicine service. A doctor can easily assess the severity of the mark via a high-quality video call and determine your immediate next steps without you having to leave the house.
Available Treatments for Infantile Hemangiomas
Here is the best news: the vast majority of hemangiomas will stop growing by the time the baby is one year old, and will slowly shrink and fade away completely (a process called involution) by the time the child is 4 or 5 years old.
Because they resolve naturally, the most common medical treatment is simply «active observation.» However, if the hemangioma is growing in a dangerous location or develops complications (such as breaking open and bleeding, forming painful crusts, or causing severe ulcers), your doctor will intervene.
Standard Medical Treatments Include:
- Oral Beta-Blockers (Propranolol): This is currently the gold-standard treatment used by pediatric dermatologists. Propranolol is a liquid medication originally used to treat high blood pressure. It has been proven to be incredibly safe and highly effective at shrinking infantile hemangiomas rapidly by constricting the abnormal blood vessels.
- Topical Treatments: For smaller, superficial hemangiomas, doctors may prescribe a topical beta-blocker gel (like Timolol) or mild steroid creams. These help stop the growth of the lesion without the need for oral medication.
- Laser Therapy or Surgery: In rare cases, if the hemangioma is unresponsive to medication and threatens a vital organ (like the eye), or if it leaves behind heavily stretched, scarred skin after shrinking, a doctor may recommend laser therapy or minor corrective surgery. However, surgery is usually excluded until the child is over 5 years old to allow the body to heal itself first.
Disclaimer: The information provided in this article by Folime is for educational and reassuring purposes only. It should not be used as a substitute for professional pediatric medical diagnosis. If a birthmark on your child is bleeding rapidly, forming open sores, or interfering with their breathing or vision, seek emergency medical care immediately.
