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Haemangiomas

Haemangiomas are benign (non-cancerous) vascular growths that appear on the skin or, rarely, internal organs. Often present at birth or appearing in the first weeks of life, superficial haemangiomas are sometimes called strawberry marks. Most are harmless, though they can occasionally cause cosmetic or functional issues, particularly near the eyes, mouth, or airway.

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Overview

What are haemangiomas?

Haemangiomas are abnormal clusters of blood vessels that form growths in the skin or deeper tissues. They are typically classified into:

  • Superficial haemangiomas (“strawberry marks”): Raised, bright red lesions visible on the skin surface.
  • Deep haemangiomas (“cavernous”): Bluish or purple lumps beneath the skin, often softer.
  • Mixed haemangiomas: Combination of superficial and deep features.
  • Congenital haemangiomas: Fully formed at birth, either involuting rapidly (RICH) or persisting (NICH).

Most haemangiomas grow rapidly in the first few months, followed by gradual shrinkage over several years.

Symptoms and Causes

How haemangiomas appear

Haemangiomas can vary in appearance depending on type, location, and depth:

  • Raised, bright red patches on the skin (superficial type)
  • Blue or purple lumps under the skin (deep type)
  • Mixed red and blue lesions with soft or firm texture

Potential complications: Most haemangiomas are harmless, but growth near the eyes, nose, mouth, or airway may cause issues with vision, breathing, or feeding.

What causes haemangiomas?

Haemangiomas result from the abnormal proliferation of endothelial cells, the cells lining blood vessels. Common contributing factors include:

  • Premature birth or low birth weight
  • Female sex (more common in girls)
  • Multiple births (twins, triplets)
  • Rare genetic predisposition

Diagnosis and Tests

Diagnosis is usually clinical, based on the lesion’s colour, size, location, and growth pattern. Most superficial haemangiomas are easily identified by a GP or dermatologist.

Additional tests

In selected cases, imaging or lab tests may be recommended:

  • Ultrasound: Evaluates depth, blood flow, and internal structures
  • MRI / CT scan: For large or complex haemangiomas near organs or airways
  • Biopsy: Rarely needed, to rule out vascular tumours or atypical growths

Management and Treatment

Many haemangiomas resolve naturally over time. Treatment is considered if they:

  • Interfere with vision, breathing, or feeding
  • Ulcerate, bleed, or cause pain
  • Present significant cosmetic concerns

Treatment options

Medical therapies:

  • Beta-blockers (propranolol): Oral or topical, shrink haemangiomas effectively
  • Corticosteroids: Used when beta-blockers are unsuitable
  • Laser therapy: Reduces redness and treats persistent or ulcerated lesions

Surgical options:
For haemangiomas causing complications or not regressing, minor excision may be performed.

Supportive care:

  • Keep ulcerated areas clean and moisturised
  • Protect skin from trauma and infection
  • Regular monitoring for rapid growth or complications

Outlook/Prognosis

The prognosis for haemangiomas is excellent:

  • Infants: Most superficial haemangiomas involute naturally by age 5–10
  • Deep lesions: May take longer to shrink and sometimes leave minor skin changes
  • Complications: Rare; some may cause scarring, ulceration, or functional issues depending on location

Early assessment and management improve outcomes, especially for haemangiomas in sensitive or critical areas.

Prevention

Haemangiomas cannot be prevented, as they are congenital. Early detection and monitoring reduce risks of complications and improve cosmetic outcomes.

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Concerned About a Haemangioma?

If you notice a rapidly growing, persistent, or functionally impactful haemangioma, don’t wait. Take a free online haemangioma assessment with Aventus Clinic today for personalised guidance and support.

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