How Often Do Hemangiomas Require Surgery?

Jan 3
2025

Hemangiomas are benign tumors made up of blood vessels and are one of the most common types of birthmarks seen in infants. Typically, they are red or purple in color and vary in size and shape. While most hemangiomas do not require treatment, many parents and caregivers often wonder about the necessity of surgery and when it might be necessary. The Vascular Birthmark Center explores the factors influencing the surgical intervention for hemangiomas, the typical course of management, and the overall prognosis.

Understanding Hemangiomas

Hemangiomas usually appear shortly after birth and can proliferate within the first year. They often follow a specific life cycle: a growth phase (proliferative phase), a stabilization phase, and eventually, involution (shrinking). Most hemangiomas regress on their own over time, often losing their color and becoming less noticeable by the age of 5 to 10 years.

When Is Surgery Necessary?

Surgery for hemangiomas is relatively rare and typically considered in specific circumstances. The following factors can influence the decision to pursue surgical intervention:

1. Location: Hemangiomas in areas that may interfere with normal bodily functions, such as the eyes, ears, nose or mouth, may require surgery. If a hemangioma threatens vision and hearing or risks causing airway obstruction, medical professionals may recommend surgical intervention.
2. Size: Large hemangiomas may require treatment more often, especially if they are growing rapidly or causing excessive pressure on surrounding tissues.
3. Ulceration: Some hemangiomas can develop ulcerations, leading to pain and potential infection. In these cases, treatment may be necessary to promote healing and prevent complications.
4. Psychosocial Impact: Though hemangiomas are benign, those that remain prominent into childhood can affect a child’s self-esteem and emotional well-being. In light of this, some parents may choose surgical removal for cosmetic reasons, especially if the hemangioma does not demonstrate signs of involution.
5. Persistent Lesions: While many hemangiomas will naturally fade over time, some may persist or not respond to other treatments such as medications. In such cases, surgery is the next step.

Alternative Treatments

Before considering surgery, your Vascular Birthmark Center specialist explores other treatment options. These may include:

• Observation: If a hemangioma is not causing problems, the most common approach is to monitor its progress.
• Medications: In some instances, corticosteroids or beta-blockers may promote regression in hemangiomas, mainly in a location that poses a risk to function.
• Laser Therapy: For some superficial hemangiomas, laser treatment may effectively reduce redness and improve appearance without surgical excision.

The Role of Birthmark Specialists

If a hemangioma is diagnosed, regular follow-up with a birthmark specialist like Dr. Gregory Levitin is essential. We will monitor the hemangioma’s growth, determine whether it is causing any concerns and establish the most appropriate course of action. Hemangiomas are somewhat common in infants, but surgical intervention is not often required. The natural history of most hemangiomas is one of regression, making observation a reasonable approach for many cases. However, specific factors related to location, size, ulceration, psychosocial effects and persistence can influence the decision to pursue surgical treatment.

If you have concerns about a hemangioma, contact the Vascular Birthmark Center and schedule a consultation to determine the best approach for your child’s situation. We have locations in New York City and Los Angeles to serve patients all across the United States.