Laser Treatment of Congenital Hemangioma

What is a congenital hemangioma?

Hemangioma – congenital benign vascular tumor, it may be invisible soon after birth but become visible within the first 6-8 weeks of the child’s life. This is the most common pediatric tumor. Hemangiomas usually grow until the age of 1-1,5 years and destroying tissues by changing their structure.

Congenital hemangioma

Is congenital hemangioma dangerous?

The most common localization of hemanginoma is the skin and subcutaneous layer, but it can be anywhere: in the respiratory tract, abdominal organs, brain, bone. If so, hemangiomas can be life threatening. 65% hemangiomas are found in skin of the head and facial areas. The most dangerous are nose, ear, eyelid, lip hemangioma. While growing, they violate the cartilaginous structures and destroy them forever.

Congenital hemangioma

Hemangioma is not only growing, it can ulcerate and bleeds. If there is a bleeding hemanginoma in the respiratory tract – it is a life-threatening condition. Increasing respiratory tract hemangioma can block the airway and the baby may die. While growing, hemangiomas can block the eye, cause eyesight disturbances, may cause developing cross-eyeness. Their treatment is very complicated.

If you can notice a lot of skin hemanginomas on the newborn, internal organs may be affected too. In this case it’s not only about hemanginomas, this sickness is called diffuse neonatal hemangiomatosis. This disease has a high mortality rate and may cause a rare, but very dangerous complication called Kasabach – Merritt syndrome, when the patient develops platelet deficiency and massive bleeding may occur.

Do you need to treat hemangiomas?

In about 70% of cases, no treatment of hemangiomas is needed; they are treated only for cosmetic purposes, after choosing an optimal age for the treatment. Treatment of hemangiomas consists of two indications: one medical, the other – cosmetic. When the hemangioma is growing rapidly – there is a medical indication for the treatment, and when it is stabile or involuting – the indications are more cosmetic.

How does the hemangioma change, when the child grows up?

The fastest growth of these tumors is when the child is 2-4 months of age. These vascular tumors are genetically programmed to vanish by themselves, spontaneously, but not every of them. 50% of hemangiomas disappear without a trace when the child reaches the age of 7 , 30% when child is from 16 to 18 years old, they involutes, usually with scar formation, 20% of haemangiomas never disappear spontaneously.

What determines the duration of hemangiomas disappearance?

It mostly depends on the location of hemangioma, its growth rate and aggressiveness. Facial hemangioma involutes significantly longer. Hemangioma spontaneous disappearance period is 12 years on average, from the time when they start to vanish, that means usually, when the child is 1 year old. Large hemangiomas disappear only partly and you usually have to remove their residuals by the laser or plastic surgery.

When you should start the treatment?

Most important – you should start the treatment as early as you can, and prevent hemangiomas from growing. In this case, the recovery period is much shorter. If the same patient has three or more skin hemangiomas, a detailed examination for the presence of dangerous abdominal and thoracic hemangiomas is recommended.

When is it necessary to treat hemangiomas?

The question “Is it necessary to treat the hemangiomas or not?” can be answered only after the patient has been examined. Face, fingers and genital hemangiomas should be treated immediately after diagnosis is made, sometimes even when the child is only a few days old. Hemangiomas located in other areas, can be observed about 4-6 weeks. If there is no growth, the observation continues, but if there is an obvious aggressive growth – hemangioma requires treatment. Indications for non-growing hemangioma are more cosmetic, but may eventually become psychological.

Are hemangiomas treated surgically?

There are various methods of treatment. They all have their advantages and disadvantages. A surgical removal of the tumor is possible, but there will be scars afterwards. In many countries, surgical treatment of hemangiomas is recommended only to remove the residuals of partially involuted hemangiomas or when other methods of treatment failed. If you removed a growing hemangioma there is a significant probability of recurrence around the post-operative scar. Sometimes, the tumor size and location makes the surgical removal impossible.

What is the most advanced treatment method for hemangiomas?

Currently, the most advanced treatment method is by medical lasers. The treatment usually takes, from 1 to 7-8 procedures. After the inflammation of the tumor’s vessels caused by the laser, the obliteration of the feeding vessels occur. That prevents the enlargement of the hemangioma and induces the regression. Laser beam is not ionizing radiation, and do not affect the status of the whole body. When you have a growing hemangioma, the first and most important goal is to stop the growth of the tumor and then force it to regress. Cosmetic correction may be carried out later; on the 3-4 year of life. One laser procedure accelerates the natural involution of hemangioma from a period of 1 to 1.5 years. Laser treatment helps to avoid surgery, scarring, tumor recurrence, etc. Treatment in right time by an appropriate laser device helps to avoid scars and long-term deformations.

Does the laser procedure require full anesthesia when dealing with children?

GK clinic use the most modern laser equipment for treatment, it allows to reduce the pain during the procedure as much as possible. Therefore, most children do not need general anesthesia; local anesthesia with the anesthetic ointment is quite enough. General anesthesia is applied, only in cases of a very large hemangioma, or if the tumors are on the face.

If you have any questions, please contact our GK Clinic by phone at (+370) 5 255 33 53 and arrange a private consultation.