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In recent time young parents have to face such term like baby hemangiomas more and more often. So, what`s hemangioma? And which threat does it bring to our babies?


What`s hemangioma?

In recent time young parents have to face such term like baby hemangiomas more
and more often. So, what`s hemangioma? And which threat does it bring to our babies?

Hemangioma - is a non-malignant vascular mass, which is a result of defect of
development of vessels during embryonic period.

Hemangiomas have following peculiarities:

- majority of hemangiomas appear in first 2-3 weeks of life and are revealed
in the first year of a baby`s life, cases of inborn hemangiomas became rather
frequent;

- these neoplasms of blood vessels can take quickly progressing character. Spontaneous
disappearance of hemangioma can be also observed.

Depending on location of hemangioma, there`re following its types:

- flat;

- torous-flat;

- torous-nodular;

- cavernous.

There`re also mixed forms. Depth of color of hemangiomas is various - from pink
to red, from cherry to dark- vinous. Color of hemangioma depends on depth of location
and size of lumen of affected vessels.

Can hemangiomas disappear without treatment?

Many hemangiomas can be subjected to spontaneous regression.

While spontaneous disappearance of hemangiomas 3 phases are prevailing: till
the end of the first year of life; from 1 to 5 years (early involution); till
the end of pubescence (late involution).

Appearance of sites of whitish skin in the center of hemangioma testifies of
a beginning process of recovery. Whitish sites can appear also on periphery, can
be located chaotically, but with time they enlarge and flow together. This process
can last for years. In 30 % of cases back development does not finish completely
with successful result and requires additional manipulations in further. Spontaneous
disappearance is not a guarantee of excellent cosmetic result. Recovery can pass
in different ways:

- change of color to lighter (depigmentation);

- applanation;

- cicatrisation.

Flat hemangiomas have biggest chances on remission with good cosmetic effect.
However, you should note, that if cankering of hemangioma preceded recovery, then
scars may appear on their places.

Where are hemangiomas located most often?

First of all, this is an area of head. In general, hemangiomas are located on
eyelids, forehead area up to hairs, near root or end of nose, on cheeks, including
area of cheeks in mouth, on conjunctiva. Area of genitals is on the second place.
Soiling of these places with urine and defecation, rubbing with diapers or cloth
can lead to appearance of small ulcers and bleeding of hemangiomas, and also infection
of these places.

Often hemangiomas are located on upper part of body, on arms and legs of a baby.
Hemangiomas can be also located in invisible places: internals, soft parts and
bones. Cases of many hemangiomas in different places are also met.

Should hemangiomas be treated?

Not less than 10 % of hemangiomas can lead to various complications in a child`s
life. Complications serve as an immediate signal to hemangioma treatment. This
can be not only cankering with infection, but also defects of functioning of organ,
strong anemia as a result of bleeding, quick growth of hemangiomas with defect
of bordering tissues.

Psychological condition of parents and baby also serves as indication to treatment
of hemangiomas. It is known, that back development of hemangiomas can be stretched
for years, and if hemangioma is located on open sites, then this may bring a certain
discomfort to a person. It is impossible to ignore such problems, fears and anxieties,
possible seclusions and isolations, family conflicts. For example, while nevus
flammeus, there`re no complications, but we can just only suppose, how difficult
it is for relatives and patient himself (in German it is translated like birthmark
or shameful sport):

- very often mothers blame themselves for such disease of their babies;

- often a fear of bleeding as a result of injuries and scratchs, which relatives
won`t be able to stop, appears;

- since kindergarten problems with other children may appear, often friends begin
teasing or exclude sick child from games at all;

- psychologically children may react to all this things with aggressiveness,
depressions, timidity or lowering of attention.

Statement, saying that hemangiomas should be cured since the earliest stage of
diagnostics or appearance, is not certain. Till now there`s an expecting tactics
among doctors, based on the fact that hemangioma may be subjected to back development.
Necessity of treatment is admitted only while presence of complications. As a
result of this retardation of therapeutic treatment much time is wasted on the
early stage of disease.

In recent time development of laser therapy changed previous approach to expecting
therapy of hemangiomas significantly. Now doctors have an efficient method of
early therapy on an outpatient basis.

Nowadays doctors keep to following approaches in hemangiomas treatment:

1. Hemangioma on face and in the area of vulvar lips and anus is rated like an
extra cosmetic case and requires 3-days treatment.

2. Hemangiomas with clear tendency to growth (increase of square of location
twice during a week) should be treated at once, and while other increase - during
a week.

3. Hemangiomas in mouth and inside of cheeks are also rated like an extra case
and should be treated with laser before a necessity of their surgical removal
appears.

4. Considering simplicity of laser method of removal of hemangiomas, it is possible
to broaden significantly list of complications of hemangiomas, while which laser
therapy is indicated.

If hemangioma is located on face or in anogenital area, then, according to mentioned
recommendations, it is rated like an extra case and an appropriate laser therapy
is started right after diagnostics. If hemangioma is located on other part of
body, then it can be observed further and while clear tendency to growth - subjected
to laser removal. If, on the contrary, a stop of growth is observed, it is recommended
to wait and use laser therapy only in case of complications. If spontaneously
disappearing hemangioma leaves scars, they also should be subjected to laser treatment
to gain good cosmetic result.

While any type of hemangioma it is necessary to document initial phase photographically,
its displays, for further control of spreading of hemangioma and process of treatment.

Previous possibilities of hemangioma treatment.

Before appearance of laser methods, all methods of hemangioma treatment gave
very high percent of complications, in comparison with possibility of spontaneous
disappearance of hemangioma.

Actinotherapy.

Nowadays this is one of out-of-date methods of hemangioma treatment. Complete
removal of hemangioma with help of appropriate doses of radiation is almost impossible.
Appearing side effects (defect of growth, defects of coverlet) do not excuse this
method.

Sclerotherapy.

With help of sclerogenic preparations, which are injected in vessels, it is possible
to gain applanation of hemangioma. Side effects: hyperpigmentation, necrosis of
tissues and other damages.

Cryotherapy.

As cryotherapy acts only skin-deep, it is used while skin forms of hemangiomas.
After repeated treatments skin turns white, and, as a rule, coarse atrophic scars
are formed, which require additional cosmetic and resolving procedures.

Cortisone (hormonal) therapy.

Presumably, while long taking of cortisone, receptors, responsible for growth
of organism, are blocked. After abolition of cortisone growth recommences. Most
likely, not all hemangiomas are connected with these receptors, as in 30 % of
cases this method of treatment have no influence. Besides internal taking of cortisone,
usage of local ointments is also possible, however, many complications may appear
(from local to general). There`s sense of using such treatment as an additional
remedy while ominous conditions.

Magnesium filling.

Pieces of wire of pure magnesium are implanted in hemangioma repeatedly. Stop
of hemangioma growth is reached this way. Only volume hemangiomas can be treated
with this method. Application of early treatment is impossible with this method.

Surgical treatment.

Surgical removal of parts of tissues, where hemangioma is located, is used. Risk
of surgical treatment is rather high because of strong bleeding during operations,
which often end up with different complications. Due to this, for example, removal
of infiltration on face is almost impossible. Moreover, disfiguring after-effects
of operation or damage of facial nerve are possible.

Laser removal of hemangiomas.

Nowadays laser therapy is an essential alternative to methods, used till now.
The main its advantage is that it is possible to treat all forms of vascular pathologies
and on any stage of disease with help of laser. Moreover, treatment can be divided
into separate stages, what can be coordinated with aesthetic needs. Laser treatment
is almost painless, however, if patient wishes, local anaesthetics in the form
of creams and ointments can be used. After laser therapy it is necessary to make
a break and wait from 2 to 6 weeks, so that inflammatory reaction would disappear
completely. Before every following procedure of laser treatment a conclusion about
previous result is made. Sometimes one procedure of laser treatment is enough
for removal of hemangioma, in other cases more procedures are required. If after
laser treatment there`re signs of hemangioma remission, it is possible to use
wait-and-see attitude and refrain from manipulations. Like with any other method
of therapy, there`s a percent of failures here too, however, it is much lower,
than while any other methods, sometimes cicatrisation may appear or hemangioma
can fall under influence of laser. This depends on right choice of laser, doctor`s
qualification, and also on individual peculiarities of skin, type of hemangioma.



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