What should parents pay attention to in the treatment of hemangioma in infants and children?

Hemangiomas are benign tumors that originate from blood vessels in the skin, mostly occurring in infants or children. They are mostly found on the skin of the head and neck, but can also occur on mucous membranes, liver, brain and muscles, etc. Bright red nevus on the occipital area is the most common. They appear at birth or within three months to six months after birth, and often occur on the head, face and neck, affecting the baby’s appearance. So, what should parents pay attention to in the treatment of infant hemangioma? 1, hemangioma receding does not mean disappearing. hemangioma can be simply divided into 2 categories: receding and non-receding. 30% recede at the age of 3, 50% at the age of 5, 70% at the age of 7, and 90% at the age of 9, but these data are only estimates. Of course, regression rates reported in the literature vary, and the likelihood of regression of hemangiomas is mostly speculative. With multiple hemangiomas, the rate of regression varies with each lesion. More importantly, it is not possible to predict whether hemangiomas will regress and whether they will cause aesthetic problems after regression. Most reports indicate that nearly 50% of hemangiomas result in permanent deformities. Parents should understand that receding does not mean disappearing completely. 2. Laser is not magic Parents of children with hemangioma always want to remove the lesion immediately and have high hopes for laser treatment. Although many units are carrying out clinical work on laser treatment of hemangioma, the value of laser treatment for infant hemangioma is actually very limited. This is because laser is a physical therapy, and for hemangiomas in the proliferative phase, laser treatment alone cannot control the continued growth of the hemangioma. Secondly, the penetration depth of laser is limited (average penetration depth is 1.2mm) and is not effective for deep (subcutaneous) hemangiomas. If the power is increased, regrettable scarring and pigmentation changes are often left behind. Therefore, laser treatment of hemangiomas is limited to superficial skin hemangiomas that have stopped growing and are less than 2 mm thick. Parents should be encouraged to use laser treatment as the ultimate treatment for residual capillary dilation rather than the conventional means of hemangioma, especially for lesions on the nose and lips. 3. Emphasis on medication Parents should understand that oral steroids are one of the time-tested treatments for hemangioma. However, short-term application of propranolol (3 to 9 months) is very effective and has replaced hormones as the first-line treatment. In children younger than 3 months, consult a cardiologist before taking the drug and measure baseline data, including photographs, ultrasound, blood work, and EKG. Hospitalization for 1 day, observe for bradycardia, hypotension, and hypoglycemia after taking the drug, and administer the drug at 2 to 3 mg/kg.d in 2 to 3 doses for 3 to 9 months. gradually stop the drug within 3 to 4 weeks. For periorbital hemangioma, local application of 1% propranolol cream or 0.5% timolol can be used.