What Is a Hemangioma?


They often look like red or pink mounds on the skin, and happen when blood vessels grow in an abnormal way. An infantile hemangioma is the most common vascular anomaly in children. They often present at or soon after birth and grow quickly in early infancy.

Infantile hemangiomas have two phases- a growth phase, and an involution (shrinking) phase. The hemangioma generally grows quickly over the first few months, and then continues to grow up until 6-12 months of life, and then they enter the shrinking phase. They are usually harmless (benign, not cancerous) but they can cause issues of disfigurement or ulceration, and can sometimes affect major organs, depending on the location and size.

cute baby with hemangioma


Why Does a Child Have Hemangioma? 

We may never know why a child developed a hemangioma, but at times they do run in families. They are more common in females, in white non-Hispanic individuals, preterm/low birthweight infants, and multiples (twins, triplets, etc.), and are associated with older maternal age, placenta previa, preeclampsia and other placental issues.

How are Hemangiomas Treated?

Sometimes, when hemangiomas are small, we may recommend a topical medication. Timolol is a beta-blocker medication that helps shrink small, superficial hemangiomas. Topical steroids can help prevent the growth of small, thin hemangiomas. Steroid injections may also be considered in rare cases.

If your child has a hemangioma that is concerning for disfigurement, skin breakdown and infection (such as in the diaper area), or may damage organs or skeletal development, we will likely suggest an oral liquid medication.

In our center, we most often use a medication called atenolol. This medication is a beta-blocker medication that helps shrink hemangiomas. It is given twice a day over many months to years. Prior to starting atenolol, your child will have an evaluation of their heart with an EKG to make sure they do not have an underlying heart problem. If your child is very young (8 weeks old or younger), they will be admitted to our inpatient unit for the first few doses of the medication to ensure that they tolerate it well. If they are over 2 months of age, we will administer the first dose in our clinic, monitor them for a few hours, and then send you home with the medication. In both cases, we will schedule your child for a follow-up visit with us in one week to check to see how your child is tolerating the medication at home.

Children are monitored every few months while on atenolol with follow-up visits and dose adjustments to account for weight gain. Once the child has reached the involution stage, the medication is carefully discontinued over a period of time.

May be considered in rare cases.

Our Team

Michael Isakoff, MD

Division Head, Center for Cancer and Blood Disorders | Director, Sarcoma Program | Director, Reid R. Sacco Adolescent and Young Adult Cancer Program | Medical Director, Connecticut Children’s Clinical Trials Unit

Christine Longyear, MSN, PNP-BC

Nurse Practitioner, Center for Cancer & Blood Disorders

Alex Golden, MD

Clinical Director, Inpatient Cardiology