My daughter was born with a hemangioma on the left cheek of her face and as of this posting it still appears somewhat prominently. Figured it would be helpful to post our experience with hemangiomas and pass along some advice and perhaps a baseline for comparison.
What is a hemangioma?
The clinical definition is the abnormal buildup of blood vessels on the skin or internally. For skin hemangiomas, the size, location, and color can completely vary. For more medical talk see https://health.google.com/health/ref/Hemangioma
It basically looks like a red mark or wound-looking blemish on the skin (see pictures below).
What causes it?
Nobody knows – you’re either born with one or you’re not. Some say it might be genetic, but there is no definitive link to a cause for this skin condition. Funny enough, we asked some immediate family members if there was any known history of hemangiomas and my Aunt (my mother’s sister – my daughter’s great aunt) had a mark on her face at birth that may or may not have been a hemangioma. Back then the doctors recommended immediate removal of it with a heat treatment, which left my aunt with a small patch of discolored skin (hardly noticeable most of her life). Hard to say if that is a genetic link because the science around skin was probably not as advanced in the 1940s as it is today.
How do you treat it?
You don’t, and the doctors we have spoken to indicate that a majority of hemangiomas go away on their own over time. They can also be removed through surgery, and in some cases surgery is recommended if the growth is invasive to breathing, eating, seeing.
Through my interactions with pediatricians and pediatric dermatologists, there is no ointment, medication, or general treatment for the removal of a hemangioma.
For our daughter, the hemangioma is on her cheek and does not hurt her or cause pain in any way.
When did you first notice it?
It’s a funny thing – when my daughter was first born she had a small dimple-like mark on her cheek. We didn’t think much of it, just figured it would be a birth mark and at that point we were so elated with her that we had little care for a small facial dimple.
After about 2 months it began to develop into a red mark, at times looking like a scab from a wound. At an early appointment, our pediatrician recognized it as a hemangioma and explained the background. Fast forward a year and the mark settled into a red and deep-blue color, looking similar to a bad black-and-blue bruise.
Overall, there were some significant changes in the first 2 years of her life and looking back at some of the pictures it’s amazing how much it changed. Take a look a the shots below and you can see the progression (images run left to right in chronological order – 2 days, 2 months, 4 months, 6 months, 9 months, 1 year, 15 months, 17 months, 23 months):
This probably goes for a variety of issues with young children – over time, my wife and I hardly noticed it. Sure, we still look at it from time-to-time and marvel at how much better it looks than in the early days, but our daughter is beautiful even with the hemangioma.
The biggest challenge is dealing with stares and the occasional questions from unknowing children and adults. We developed a speech we would repeat in various forms when people asked.
For children, we just explained that it was a birth mark and it will go away when she’s older. Most kids usually move on from there, unless they are my nephews who always want to touch it.
Ironically, adults tend to be more challenging. First, the nature of the question always varies in levels of tactfulness. Here are some examples of adult inquiries about my daughter’s hemangioma and my assigned level of tact with the question (1 through 5: 1 being tactless and 5 being innocently classy):
The important lesson here is that these types of questions are going to pop-up. Try not to get too defensive about it. People question what they don’t understand and for most, they are accustomed to babies with soft, gentle, unblemished skin. A hemangioma is alien to them.
One other point here – we were amazed by how many parents would tell us about hemangiomas they have come across on their own children, friend’s kids, nieces, nephews, etc. In almost all cases they reassured us that the mark will go away at some point and we just need to be patient.
And now we wait. Based on the feedback we have heard from our Pediatric Dermatologist, there is a high likelihood that the mark will eventually fade away and show no signs of ever being there to begin with. However, no one can accurately guess at how long it will take for the skin to be clear.
Surgery is definitely an option, although not recommended until the child is older or if the hemangioma is causing an impediment on eating, breathing, vision, etc. For our daughter, this mark is non-invasive, and more of a cosmetic issue. Additionally, surgery would most likely require the child to be put under general anesthesia and may leave a scar. For us, these two factors rule out surgery right now.
We plan to wait a few more years, until she’s about 5 or 6, and then make a decision on surgery or not. We figure that by the time she gets to school there will be questions and potential teasing by other kids, and every parent would like to avoid their child being the center of attention in that regard.
Having said that, I think this will be a decision for our daughter as well. I’d like to empower her to contribute to a decision like this, since it’s her face after all, hence another reason to wait until she’s older.
In the end, hemangiomas like my daughter’s are just cosmetic blemishes and really small potatoes in the large realm of other problems that can face young children. With that said, it can be a challenging experience for new parents – of course we want our kids to be perfect in every way, but more often than not, it doesn’t end up that way. If your child ends up with a visual hemangioma, talk to your doctor, see a few pediatric dermatologists for multiple opinions, and enjoy your child regardless.
You may also be interested to read: Hemangioma Q&A with Dr. Gregory Levitin