Khansa Plastic Surgery
Schedule a hemangioma evaluation with Dr. Khansa
Hemangioma
A hemangioma is a benign (non-cancerous) mass that is composed of endothelial cells. Endothelial cells are the same type of cells that line blood vessels. Hemangiomas are very common, occurring in about 10% of newborns.
The exact cause of hemangiomas is unknown. They are not caused by anything a mother did or did not do during pregnancy. They appear when extra blood vessels form a dense cluster rather than a typical, organized vascular network.
Types
Infantile hemangiomas are usually small, flat, or not present at birth. They start to grow a few weeks after birth. They grow for the first year of life. After a year, they usually stop growing and then start shrinking over a period of several years. This is known as "involution".
Rapidly-involuting congenital hemangiomas (RICH) are usually fully grown at birth, and then they rapidly shrink/involute over a period of several weeks to months.
Non-involuting congenital hemangiomas (NICH) are usually fully grown at birth. They remain the same, neither growing nor shrinking after birth.
Dr. Khansa will be able to tell you what type of hemangioma your child has.
Symptoms
Most hemangiomas do not cause any symptoms or problems. Many infantile hemangiomas behave as expected, growing in the first year of life, then involuting and eventually disappearing. Therefore, most hemangiomas do not require any treatment.
However, sometimes a hemangioma might cause issues because its location, size, or growth. Those hemangiomas are more likely to require treatment. Examples of problematic hemangiomas include:
A large hemangioma in a cosmetically-sensitive area, such as the face or the hands
A hemangioma affecting the eyelids or the area around the eyes, and causing obstruction of the visual fields
A rapidly-growing hemangioma that causes ulceration (a painful non-healing wound that drains and bleeds)
A hemangioma inside the airway, causing breathing difficulties
Multiple large liver hemangiomas
Dr. Khansa will help you figure out whether your child's hemangioma should be treated.
A large infantile hemangioma of the right lower eyelid causing visual obstruction
Treatment
Depending on their location, size and growth, symptomatic hemangiomas can be treated in several ways:
Timolol: this is a topical gel that is applied to the hemangioma twice a day. It is effective for small, superficial hemangiomas
Propranolol (Hemangeol): this is an oral medication that can be very effective at treating most hemangiomas. It is given 3 times a day with food.
Laser: pulsed-dye laser can be used to decrease the amount of red color in e hemangioma
Surgery: surgical excision can be used to remove a large or problematic hemangioma
Dr. Khansa will help you determine the best treatment for your child's hemangioma.
FAQs
🔍 How do infantile hemangiomas progress over time?
Infantile hemangiomas typically go through three distinct phases:
Proliferative phase: Rapid growth during the first 12 months months of life
Plateau phase: Growth stabilizes, usually around 1 year of age.
Involution phase: Gradual shrinking and fading, which takes place over several years
🔍 How are hemangiomas diagnosed?
Most skin hemangiomas are diagnosed purely through physical examination and medical history. Deep hemangiomas or internal hemangiomas (such as liver hemangiomas) are usually detected incidentally using imaging modalities like ultrasound.
🔍 Do all hemangiomas require medical treatment?
No. Most small infantile hemangiomas do not require active intervention and naturally shrink on their own. Only hemangiomas that are causing anatomic distortion or symptoms need treatment. Examples of symptoms that require treatment include cosmetic distortion, ulceration, rapid growth, functional impairment, visual obstruction or airway obstruction.
🔍 What is the difference between a hemangioma and a vascular malformation?
Infantile hemangiomas are cellular tumors that grow rapidly after birth and eventually shrink (involute). Vascular malformations are structural birthmarks composed of abnormally formed blood vessels. They tend to grow with time, and do not naturally shrink over time. Vascular malformations include venous malformations, lymphatic malformations and arterio-venous malformation. The management and treatment of hemangiomas is completely different than vascular malformations. It is important to get the opinion of an expert in the field of hemangiomas and vascular malformations, such as Dr. Khansa, to make sure your child receives the best treatment possible.
🔍 What risk factors increase the likelihood of infantile hemangiomas?
Infantile hemangiomas occur more frequently in:
Premature infants or babies with low birth weight.
Female infants (3 to 4 times more common than in males).
Multiple-gestation pregnancies (twins, triplets).
🔍 What is PHACE syndrome, and how does it relate to hemangiomas?
PHACE syndrome is a rare condition involving a large, segmental hemangioma (usually covering a significant area of the face or head) associated with structural anomalies of the Posterior fossa (brain), Hemangioma, Arteries in the head/neck, Cardiac abnormalities, and Eye abnormalities.
🔍 What causes ulceration in a hemangioma, and how is it managed?
Ulceration happens when the overlying skin breaks down, often from friction, moisture, or rapid hemangioma growth. Ulceration is often seen in hemangiomas of the diaper area. Management includes wound care, barrier ointments, and propranolol.
Why choose Khansa Plastic Surgery for hemangioma treatment in Austin?
Harvard Medical School graduate
Certified by the American Board of Plastic Surgery (ABPS)
2026 Austin Monthly Top Doctor
Over 70 peer-reviewed publications. World-renowned researcher.
Treats adults and children
Expert in all the different treatments of hemangiomas
Focuses on both cosmetic and functional concerns simultaneously
Evening and weekend consultations available
Conveniently located off the Mopac at 3305 Northland Dr., Suite 210, Austin, TX 78731