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Should I have my daughter’s hemangioma removed?
Q: My 9-month-old daughter has a small strawberry patch under her eye connected to the eyelid. It formed three weeks after she was born, grew for about a month and has been the same size ever since. I feel that it will mess her vision up, and it could be a problem in the future if kids picked on her. Should I get it removed or leave it?
A: Amanda, your baby has what’s known as a hemangioma, an unusual collection of blood vessels in the skin. They’re often referred to as “strawberry patches” or “strawberry hemangiomas” because of the round, red, strawberry-like appearance on the surface of the skin. Deeper hemangiomas can appear more purple or blue.

Hemangiomas are actually quite common in young children. About 10 percent of Caucasian babies have them, although they’re a lot less common in other races. They’re even more common in premature babies. While some babies are born with a hemangioma, most arise within the baby’s first four weeks of life, like your baby’s. Also like your baby’s, most hemangiomas grow on the face, although they can grow anywhere else on the body and even on internal organs. Most children have only one hemangioma, but some children have many. Hemangiomas tend to grow most during the first six months of life and have slower growth or no growth between 12 and 18 months of age. After that period, they naturally start shrinking. About 50 percent of hemangiomas disappear by the time a child is 5 and 90 percent disappear by the age of 9. About half of hemangiomas disappear completely, and half may leave some floppy skin, a slightly veiny appearance or scarring.

Most hemangiomas don’t cause any medical problems. But hemangiomas on the eyes can cause vision problems, and those on the nose, mouth or ears can interfere with breathing, eating, speaking or hearing. Occasionally hemangiomas can bleed or be tender to touch. Unfortunately, other people can make insensitive comments about a child’s hemangioma, and make you and your child feel self-conscious.

Be sure to talk with your pediatrician about your daughter’s hemangioma. Ask for a referral to a dermatologist or plastic surgeon to evaluate it and determine whether treatment would be helpful. Since it’s on her eyelid, it would also be helpful to get a referral to an ophthalmologist to evaluate her vision. Since your daughter’s hemangioma is small and will probably start shrinking soon, the doctors might recommend just waiting and watching it. However, treatment with steroids (either by mouth or injection into the hemangioma) or laser surgery is often recommended for hemangiomas on the eyes, nose, lips and fingers, and generally has good results. New treatments are always being developed, so be sure to ask your doctor about them.

For more information, visit the Vascular Birthmarks Foundation at www.birthmarks.org.

Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician