Strawberry-hemangioma

How do hemangiomas and port-wine stains develop?
The exact cause of hemangiomas and port-wine stains is not known.

What are the characteristics?
Hemangioma:

• Often starts as a light red or pale spot with small red dots or veins.
• Grows in the first few months into a purple-red tumor or thickened area (strawberry-like).
• Deep hemangiomas appear bluish and show up later.
• Changes color when crying or in cold temperatures.
• Can rupture, causing a wound that heals slowly.

Port-wine stain:

• Pink to purple discoloration, often on the face.
• Remains flat at birth, but may darken and thicken over time.
• Never disappears spontaneously.

How is the diagnosis made?
A hemangioma can initially be confused with a bruise, a stork bite, or a port-wine stain. Once it starts growing, the diagnosis is clear. In rare cases, a biopsy is needed.
A port-wine stain is recognizable right after birth.

What is the treatment?
Hemangioma:

• No treatment is needed unless it interferes with the eyes, nose, or airways.
• Corticosteroids (like prednisone) can slow the growth. This can be administered via an injection or liquid, but may have side effects such as stomach issues and growth inhibition.
• Vincristine (in severe cases) may cause gastrointestinal issues, hair loss, and blood abnormalities.
• Laser therapy can be effective for superficial hemangiomas.
• Beta-blockers (propranolol) show promising results.
• Surgery is rare but may be necessary when vital structures are at risk.

Port-wine stain:

• Laser treatment with a dye laser is the preferred method. This process often requires multiple sessions.
• Plastic surgery may sometimes be used to remove small port-wine stains.
• Camouflage with makeup is possible.

What can you do yourself?

• Consult a doctor if a hemangioma covers a large part of the face, is near the eyes, nose, lips, or in the ear.
• Further examination is needed if a hemangioma is located on the spine (possible link to spina bifida).
• If there are more than five hemangiomas, check for internal hemangiomas (e.g., in the liver).

What are the outlooks?

• Hemangiomas usually shrink after 12-18 months and disappear in most cases before the age of 10.
• The 10%-rule: 50% disappear around 5 years, 70% around 7 years, and 90% around 9 years.
• Residual effects: Sometimes, a thin, floppy skin, enlarged blood vessels, or a bulge remains. A plastic surgery procedure may be required.
• Port-wine stains never disappear spontaneously and can thicken and darken over time.