Thanks to my cute patient’s parents who let me snap a pic of their baby’s arm to show an example of this red spot. These common little red spots are called capillary hemangiomas. Capillary hemangiomas (sometimes called infantile hemangiomas) are benign vascular malformations. They are essentially birthmarks, or areas of the skin, that develop too many little blood vessels. They are funny little birthmarks, because they may not be noticeable in the first few weeks of life. Then they start to grow. And grow they do. They often grow faster than the child (which is entirely alarming to parents). However, this is the normal evolution of the marks. As they grow, they essentially outgrow the blood supply and start to go away. So after getting bigger, they start to turn a blue hue, then eventually fade away. At their biggest, they are raised, intensely red, and may have a slightly bumpy appearance to them.
Should they be treated?
The short answer is no. Capillary hemangiomas are benign and self-resolving. However, sometimes they need to be removed or treated if they happen to be interfering with a vital structure where waiting isn’t an option (e.g., the eye, throat, mouth). If they aren’t causing a problem, it is best to leave them alone (the body does the best cosmetic job of resolving them).
Where do they occur?
They can happen anywhere on the body, but are most commonly on the head and neck.
Who gets them?
Anyone can get a capillary hemangioma, but certain groups are more likely than others. They are far more common in females, Caucasians, and premature/low birth weight babies.
What’s the timing on involution?
Every child is different and I can’t tell you for certain what will happen with your child. However, most commonly capillary hemangiomas grow the most rapidly in the first 6 months of life. Some will resolve as quickly as 1-2 years. Statistically, 60% resolve by 5 years of age, and 90% resolve by 9 years of age.
Should I worry?
Generally speaking, you shouldn’t worry about a capillary hemangioma. However, it is definitely something you should bring to your pediatrician’s attention (although, your pediatrician should notice the marks at any well child check). The concerns with capillary hemangiomas are a handful. If there are many of them, it can indicate internally located hemangiomas as well (in which case, your pediatrician will likely do further imaging tests). It is also worrisome when the hemangioma impinges on a vital structure. Finally, if capillary hemangiomas get cut or scraped they can be nearly impossible to get to stop bleeding (because of the intense vascularization). In that case, you may need to seek medical care to get it to stop bleeding (e.g., cauterization).
If your child has a capillary hemangioma, take heart. Even though they may not be exactly pretty, at least they are benign and tend to go away.