Several misconceptions about hemangioma treatment

There are many treatment methods for hemangioma, including surgical resection, laser treatment, local injection drug treatment, oral drug treatment, copper needle treatment, minimally invasive interventional treatment, radiofrequency ablation treatment, radiation (isotope strontium 90) treatment and cryotherapy. Each treatment method has its own advantages and disadvantages and certain indications. It is not true that a certain method can cure all hemangiomas as some media said. Through long-term clinical observation, we found that there are several misconceptions about the treatment of hemangioma among patients. Misconception 1: Cognitive misconception, i.e., patients’ families and some medical personnel tend to call all visible skin vascular lesions hemangiomas. In the past, the naming and classification of hemangioma were divided into capillary hemangioma, cavernous hemangioma, trapezoid hemangioma and mixed hemangioma according to their morphology. Because of their confusing concepts, they not only do not help much in understanding the course of the disease and guiding treatment, but also lead to medical complications from overly aggressive treatment, while some are too conservative and the lesions expand after the disease develops, missing the good opportunity for early treatment. For example, according to the traditional classification, strawberry hemangioma and wine stains (nevus) are both capillary hemangiomas, but the former grows rapidly and rises above the skin after birth, and most of them can subside later, so they are effective in hormone therapy and can be controlled by appropriate intervention therapy for rapid growth; while the latter grows slowly with body growth and becomes purple-red or thickened, which is ineffective in hormone therapy and will not subside naturally, so active treatment is required. Currently, congenital vascular disorders of the skin are divided into two categories: hemangiomas and vascular malformations. Strawberry hemangioma is a real hemangioma, and its tumor undergoes rapid growth, degeneration and completion of fading, which is effective for hormone treatment and most of them can fade away naturally; while trapezoid hemangioma, cavernous hemangioma and wine discoloration (erythema) are all vascular malformations, which will not fade away naturally and are ineffective for hormone treatment. This classification method is more scientific and reasonable, which is conducive to clinical diagnosis and treatment, and is widely accepted by scholars at home and abroad, but in China, there are still many doctors who have confusion in their understanding of vascular disorders, causing patients to be transferred to and from different hospitals, not knowing what to do. Correct diagnosis is a prerequisite for treatment. Only when the type of vascular lesion and the stage of development are clearly defined can we choose the appropriate treatment method and achieve the purpose of effective treatment. Myth 2: Misconceptions, that is, some patients’ families believe that hemangioma does not need treatment. Confucius said: body hair and skin, received by the parents, do not dare to destroy, the beginning of filial piety. Influenced by the traditional Chinese concept, some patients’ grandparents and grandparents are opposed to treatment, believing that the lesions are brought about by the fetus and cannot and do not need treatment. When the lesion expands and already seriously affects the patient’s function and appearance, only then do they come to the hospital. By this time, the best time for treatment is often missed. Therefore, when young children are found to have skin vascular lesions, they must go to the hospital as soon as possible to get a clear diagnosis and prevent the problem. Misconception 3: surgical misconception. First, they are afraid that the children are too young to tolerate surgery, and second, they have an instinctive fear of surgery, and some patients’ families cannot accept surgical treatment, but try non-surgical methods such as laser, freezing and radiotherapy. In this way, the best time for treatment of vascular malformation is missed instead. In fact, doctors are very careful in choosing the treatment modality. Only early vascular malformations with small scope and limited lesions are preferred by doctors for surgical removal; while when vascular malformations enter the destructive and decompensated stages, their scope is often larger and they have already invaded major organs, and the risk of surgery is higher, so doctors usually do not choose surgical removal. Therefore, the patient’s family should feel grateful when the doctor advises the patient’s family for surgical treatment.