What is a hemangioma?A sponge of blood, medical hemangioma, is a benign tumor. Your pediatrician may talk about a tumor, but that should not worry you. Tumor only describes the fact that it is a change in the tissue. In a sponge of blood, small skin vessels expand or proliferate like a sponge, hence the name.
Blood sponges are common in newborns, affecting about one to three percent of all infants (Fritsch 2004), with around 30 percent of blood sponges present or visible at birth, with 70 percent occurring between the second and fifth week of life, Girls are five times more likely to be affected than boys (VBF 2006).
Unlike normal mothers and birthmarks, the sponge initially grows and in most cases shrinks again until it disappears. Most other birthmarks remain unchanged.
Only rarely have hemangiomas reached full size at birth. They can continue to grow for up to 18 months, only then can they slowly recede. That sometimes goes very slowly. It can take anywhere from three to ten years until a sponge has completely disappeared (VBF 2006). But it can also be faster. About 80 percent of the blood sponges disappear gradually, either completely or at least partially (Fritsch 2004).
Some hemangiomas are small and unremarkable, but others are very large and disfiguring - mainly because they occur in the face and neck in four out of five cases (VBF 2006). But they can form anywhere where there are blood vessels (ie all over the body, also internally). Even if they disappear by themselves, hemangiomas can leave scars that look ugly for a lifetime (Kim, 2004).
The cause of hemangiomas is unclear (VBF 2006), but presumably they are not genetic (Pittman 2006). You as a parent should not feel guilty about that, you did not do anything wrong. It is important to have an accurate diagnosis as soon as possible in order to start treatment.
What do blood sponges look like?There are different forms and depending on the stage of development the hemangiomas look different. In infants, there are two main types: Depending on how deeply they go under the skin, a distinction is made between capillary (superficial) and cavernous (deep) forms. In the beginning, they usually appear as a bluish or pale red spot on the skin.
Capillary hemangioma. Capillaries are very small blood vessels, as a result of which the blood sponge formed therefrom is relatively small. It is red and forms on the skin or mucous membrane. They look strawberry-like and in most cases self-form.
Cavernous hemangioma. These sponges are formed in larger blood vessels and, depending on their depth in the skin, are subdivided into cutaneous and subcutaneous hemangiomas and a mixture of the two. The cutaneous hemangioma is reddish and forms a soft knot on the skin, which can also shimmer bluish. It usually forms without treatment. The subcutaneous hemangioma is flatter and shimmering bluish, it is not so sharply defined. This tumor rarely forms on its own (Klinikum Bremen-Mitte, undated).
Are hemangiomas harmless?In most cases they are not pretty to look at but harmless. The hemangiomas that you do not see can be dangerous. Some do not grow on the skin but on the body, blocking vital organs or obstructing breathing, sight, hearing or even food intake. This also applies to sponges that grow very close to the eye or ears. These sponges should be removed as soon as possible.
The following signs may indicate an internal hemangioma:
- a yellowish skin color that indicates jaundice
- blood in the stool
- Strong breath sounds (whistling or hissing, barking cough) and difficulty breathing
Also, see a doctor if the tumor grows very fast and / or changes shape.
However, the majority of sponges are safe, do not heal or cause discomfort. Sometimes they are sensitive to pressure or may catch fire. But they are disturbing especially from an aesthetic point of view.
How can you treat it?To treat, an accurate diagnosis should first be made. By ultrasound or rarely a computed tomography, the exact size and depth of the hemangioma can be determined. The perfusion is measured with a vascular Doppler.
It is often simply waited to see if blood sponges that are not life-threatening regress themselves. If this happens in the first year of life, treatment is usually unnecessary, although the risk of scarring remains. But the treatment methods often have negative consequences, so parents should consider whether they should remove the sponge for cosmetic reasons or not. Treatment may be useful if the hemangioma disfigures the face, does not regress, and your child may be teased by others, but that will not be the case in the first two years of life.
Treatment is usually with a laser therapy or by an icing (cryotherapy). The latter, however, is painful, it can cause swelling and leave scars (Klinikum Bremen-Mitte, undated). In some cases, the tumor is removed surgically. Irradiation is rarely done today because the damage caused by the treatment is too severe (Fritsch 2004).
Large capillary hemangiomas can also be treated with drugs, such as steroids (Fritsch 2004).
Depending on the size of the hemangioma, treatment may take one to several sessions. After each treatment of a spongy sponge, they should have the site checked regularly by the doctor.
What can I do?You can not prevent the blood sponges and you can not do anything yourself to prevent them from growing or to speed up the disappearance. You can try one of the above treatments, but if you have opted for laser or icing therapy then you can only wait. Remember: As long as the sponge does not affect your baby's hearing or vision, it is completely safe and does not cause any pain. However, watch the tumor very closely and go to the doctor if it grows quickly and does not regress even after several months.
As your child grows older, at some point, he'll wonder about the tumor on his face and maybe you'll have to explain to him what it's all about. A very nice child-friendly explanation provided Blutschwaemmchen. info: ""God gave you a peck.""
Fritsch, P.: ""Dermatology and Venereology"", Springer 2004.
Haggstrom AN, Drolet BA, Baselga E, et al. ""Prospective study of infantile hemangiomas: clinical characteristics predicting complications and treatment"". Pediatrics 118 (3), September 2006, pages 882-7, Read Online [as of December 2008].
Kim HJ, Colombo M, Peace IJ. ""Ulcerated hemangiomas: clinical characteristics and response to therapy."" J Am Acad Dermatol. 2001; 44, pages 962 -972
Klinikum Bremen-Mitte, undated. Health Nord, Medical Guide, undated. ""Blood Sponge (Hemangioma)"", PDF file [47 kb] [as of December 2008]. Pittman 2006, Pittman KM, Losken HW, Kleinman ME, et al: ""No Evidence for Maternal-Fetal Microchimerism in Infantile Hemangioma: A Molecular Genetic Investigation"". Journal of Investigative Dermatology (2006) 126, pp. 2533-2538. Published online on August 17, 2006 [as of December 2008].
VBF 2006. Linda Rozell-Shannon, Glenda N. Ethington: ""Facts about Vascular Birthmarks and Tumors,"" Vascular Birthmark Foundation. Undated. PDF file [62 kb] [as of December 2008].
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