Birthmark Hemangiomas of Infancy Treatment
The vast majority of hemangiomas of infancy can be treated with watchful waiting. Parents should be re-assured. Photographs showing the natural history of hemangiomas of infancy are extremely useful to reassure parents.
When hemangiomas of infancy are complicated by ulceration, they are capable of causing permanent deformity. Ulcerated hemangiomas of infancy and those that are life threatening should be actively treated.
Oral systemic corticosteroids at doses of 2 to 3 mg per kg, for 2 to 10 months are the mainstay of therapy.
Intralesional corticosteroids (Kenalog at 1-2 mg/kg) are utilized to assist with more rapid involution of the hemangioma.
Interferon alpha and vincristine are considered for life-threatening hemangiomas or hemangiomas that fail corticosteroids.
Interferon alpha is very effective but the neurological complication, spastic diplegia, limits its use to severe life threatening hemangiomas of infancy.
Surgical excision can be an option for patients with ulcerated lesions or well localized hemangiomas.
Pulsed-dye laser can be useful for infants with ulcerated hemangiomas.