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Congenital Hemangiomas

What Is a Congenital Hemangioma?

A congenital hemangioma (hee-man-jee-OH-muh) is a type of birthmark that happens when a tangled group of blood vessels grow in or under a baby's skin. Congenital means present at birth, so babies who have these hemangiomas are born with them.

Congenital hemangiomas are less common and act differently from other kinds of hemangiomas seen in newborns.

What Are the Signs & Symptoms of a Congenital Hemangioma?

Most congenital hemangiomas are a circle or oval, but they can take any shape. They can be as large as 10 cm, and may range in color from pink to blue to very dark purple. They might look swollen and feel warm to the touch.

The types of congenital hemangiomas are:

  • rapidly involuting congenital hemangioma (RICH). This type of hemangioma shrinks (involutes) without treatment and is mostly gone by the time a child is 12–24 months old.
  • non-involuting congenital hemangioma (NICH). This type of hemangioma does not shrink.
  • partially involuting congenital hemangioma (PICH). This type of hemangioma has areas that do shrink over time and others that do not.

A congenital hemangioma grows during pregnancy and typically is fully formed when a baby is born. After birth, a congenital hemangioma may grow as the baby grows. This is called proportional growth. A RICH may have some proportional growth before it starts shrinking. A NICH will continue proportional growth until the child is fully grown.

What Causes a Congenital Hemangioma?

Congenital hemangiomas are fairly rare. What causes them isn't known. No risk factors or genetic causes have been found, though hemangiomas sometimes run in families.

How Are Congenital Hemangiomas Diagnosed?

Often, congenital hemangiomas are seen before birth on ultrasound images. If they're not, doctors can diagnose can diagnose them after a baby is born by doing an exam and ordering tests, such as an ultrasound to look at blood flow. An MRI may also provide helpful information about the hemangioma's size, blood flow, and connection to other body parts or blood vessels.

Doctors may do a biopsy to see what type of congenital hemangioma a child has and to help decide how to treat it. They'll looks at cells from the sample under a microscope.

How Are Congenital Hemangiomas Treated?

A RICH usually won't need treatment because most shrink on their own. The skin usually looks better if a hemangioma shrinks naturally rather than being treated.

Doctors might treat a congenital hemangioma if it:

  • has broken down the skin (ulcerated)
  • bleeds often
  • affects breathing or vision
  • makes the heart work too hard pumping blood
  • continues growing after the baby's birth

They might use these treatments:

  • ligation: doing surgery to tie off the blood supply to the hemangioma
  • excision: removing the hemangioma with surgery
  • embolization: placing a long, thin tube (catheter) in the blood vessel to block blood flow to the hemangioma

What Else Should I Know?

After a congenital hemangioma shrinks or is surgically removed, it's unlikely to come back. It may leave a flap of stretched skin that can be surgically removed.

A baby born with a congenital hemangioma does not have any higher risk for other health problems than other newborns.

Reviewed by: Steven M. Andreoli, MD
Date Reviewed: Feb 1, 2021

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