Infantile haemangiomas

Infantile haemangiomas are benign vascular tumours that occur in approximately 10% of infants. Premature babies and girls are more frequently affected. There is also a familial clustering. Most haemangiomas are located in the head and neck area.

The exact cause is still unclear, but they show a characteristic growth pattern. At birth, they are often not yet recognisable or only as a subtle pale spot. After a few weeks, they then begin to grow rapidly. After five to six months, 80% infantile haemangiomas have reached their maximum growth. They then enter a stable plateau phase. From the first birthday, they enter the regression phase. From now on, they slowly regress. The regression can last until school age and in 50% of cases a residue (e.g. still visible fine vessels or excess tissue) remains.

Cutaneous infantile haemangiomas affect the skin and are usually reddish plaques, subcutaneous infantile haemangiomas grow in the subcutaneous tissue and appear as a livid, shimmering swelling; they usually only manifest themselves at two to three months. There are also mixed forms.

Infantile haemangiomas are harmless in most cases and do not need to be treated. However, if an infantile haemangioma is expected to limit the child's future function (e.g. in the area of the eyes or mouth) or leave a disfiguring residue, treatment is indicated or should be considered. This is usually carried out with timolol gel locally or propranolol per os. These are beta-blockers that inhibit the growth of the haemangioma. In order to prevent re-growth, this must be administered until after the first birthday, until the haemangioma enters the regression phase. As this is a cardiac medication, a cardiological check-up must be carried out when systemic therapy with propranolol is initiated. We will also closely monitor your child in our specialised consultation until at least their first birthday.

If a disturbing residual remains until school age, it can usually be treated with laser treatment or surgery.

Infantile haemangiomas must be distinguished from the rare congenital haemangiomas, which are already fully formed at birth and no longer grow. These show different rates of regression and cannot be treated with medication. Vascular malformations are a further differential diagnosis.