Hemangioma is the most common type of vascular malformation, also known as birthmark. It is a benign tumor that originates from residual embryonic angiogenic cells. Hemangiomas are most common in infants at birth or shortly after birth. 60%~70% of hemangiomas may subside before the age of 8 years, but some hemangiomas may continue to increase in size and spread rapidly, resulting in changes in appearance and dysfunction, causing psychological disorders and inconvenience in the patient’s daily life. Are hemangiomas common? Hemangiomas are the most common benign tumors in infants, with an incidence of about 4-10%. They are usually more common in girls, about 3-5 times more common than in boys. They are more common in the white race than in the yellow race and are rare in the black race. The incidence of preterm low birth weight (weighing less than 1 kg at birth) is as high as 25%, while the incidence of twins is also higher. What causes hemangiomas? Although there is a family history of hemangiomas in 10% of infants, it is not a genetic disease. There are no known foods or medications that can cause hemangiomas, and there is no association with maternal behavior during pregnancy. Current research suggests that there may be a link to a genetic mutation that occurs during the transformation of progenitor cells to endothelial cells within the fetus. When do hemangiomas appear? Hemangiomas are detected at birth in about 1/3 of affected children. Usually, the average time for hemangiomas to appear is when the infant is two weeks old, while deep hemangiomas may not be detected until 3 to 4 months of age. Adults rarely develop hemangiomas. Where do hemangiomas occur? About 60% of hemangiomas occur in the head and neck, about 25% in the trunk, and about 15% in the extremities. The vast majority (about 80%) of hemangiomas occur in a single site, and a few can occur in multiple sites. Although most hemangiomas occur on the surface of the body, a small percentage can occur in the liver, gastrointestinal tract, and even inside the brain. What does a hemangioma look like? The appearance of a hemangioma depends on a number of factors, including whether it grows on the surface of the body or deeper, whether it is proliferating, stable, or receding, and whether it is discovered at birth or after birth. Hemangiomas that are on the surface of the skin are called superficial hemangiomas, and they are usually bright red in color, similar to strawberry, which is why they used to be called “strawberry hemangiomas”. At the same time, subcutaneous veins can be seen radiating along the tumor. As the hemangioma fades, the color of the hemangioma will gradually become lighter, and usually by the age of 7, the color of the hemangioma will have completely faded. Hemangiomas underneath the skin are called deep hemangiomas and appear as bruises or light blue, and some are not visible at all. This type of hemangioma is usually not detected until the baby is 2-4 months old. When parents see these images, they must know that each case is unique and not all hemangiomas that look the same as their child’s appearance will change in the future, and that specialized knowledge must be sought from a hemangioma doctor in order to achieve the best possible outcome for their child. Can hemangiomas be prevented? There is no way to prevent hemangiomas that we know of at this time. Nothing a mother does before or during pregnancy has anything to do with the development of hemangiomas. When should I consult a hemangioma specialist? Although most hemangiomas are small and go away without any treatment, a consultation with a hemangioma specialist is necessary as he or she can give professional advice to the parents and can determine the future course of the hemangioma during follow-up visits. It is important to take your child to a doctor if the diagnosis is unclear, the hemangioma is large and fast-growing, or if the hemangioma is complicated by other symptoms. If the child has multiple hemangiomas, it is important to see a doctor because it is necessary to exclude the presence of hemangiomas in the internal organs, including the liver and digestive tract. Because these areas are more dangerous if a hemangioma is present, it needs to be treated. What are the complications of hemangiomas? Complications of hemangiomas include ulcers (breaks in the skin) leading to bleeding or infection, damage to vital organ function, disfigurement, and more rarely, heart failure. Ulcers usually develop in 5-10% of hemangiomas, especially on the lips, around the anus, or around the genitals. Local debridement and antibiotics are effective in treating ulcers, and if there is bleeding, the wound can be pressed to stop the bleeding. Ulcers usually heal within a few weeks and do not come back. However, some may leave scars. If a hemangioma affects your breathing, hearing, vision, or eating, you should see a doctor right away. How are hemangiomas diagnosed? Most hemangiomas can be diagnosed by physical examination and medical history. Sometimes it is necessary to distinguish them from vascular malformations, including venous malformations and lymphatic malformations, which are treated in different ways. If a mass cannot be diagnosed as a hemangioma or a vascular malformation, a color Doppler ultrasound can be performed to differentiate. CT or MRI may also be performed if necessary. If malignancy is suspected, a puncture biopsy, which is an invasive procedure, may be required. How are hemangiomas treated? The vast majority of hemangiomas do not require treatment other than observation, as they resolve on their own and in most cases completely, some may leave scars or slight changes in skin color. If this is the case we can use laser or plastic surgery before the child starts school. Hemangioma must be treated when the following conditions occur: 1, rapid growth of hemangioma; 2, large hemangioma with hemorrhage, infection and ulcers; 3, hemangioma endangers the patient’s life functions, such as affecting feeding, breathing, swallowing, hearing or vision, excretion or motor function, etc.; 4, hemangioma with thrombocytopenia syndrome (Kasabach-Merritt syndrome); 5, hemangioma with high-output cardiac failure; 5, hemangioma with high-output cardiac failure; 6, hemangioma with high blood pressure; 7, hemangioma with high blood pressure; 8, hemangioma with high blood pressure; 9, hemangioma with high blood pressure. Hemangioma with high-output heart failure; 6. Lesions invading important facial structures such as eyelids, nose, lips, midriff, and auricles. Treatment includes medication, surgery or intervention. Medications include corticosteroids, vincristine, or interferon. Surgery can be performed to remove hemangiomas when they grow on the upper eyelids or obstruct the airway. Surgery can be performed when the tumor is in the upper eyelid or obstructs the airway. However, surgical removal can cause scarring. Currently, interventional embolization is a good treatment for large hemangiomas to block blood flow. Other treatments include laser and radiopaque therapy. The general principle of treatment is that children should receive individualized, minimally invasive, and effective treatment.