Parents of children with hemangioma have many confusions, and there used to be a big controversy in the medical community. —- Will infantile hemangioma disappear by itself? Infantile hemangioma (IH) is the most common benign tumor in children, about 60% of which occurs in the head and neck. According to the process of lesion development, hemangioma can be divided into 3 stages: proliferative stage, regressive stage and complete regressive stage. Since hemangiomas have the characteristic of receding on their own, many doctors used to advise parents to “wait and see, the child will recede on its own when it grows up”, i.e. the “wait and see” treatment strategy. In fact, many types of hemangiomas grow larger and larger, putting the child’s health at risk. Numerous clinical observations have shown that natural regression is contradictory to the “wait and see” treatment strategy, because the natural degeneration of hemangiomas often leaves behind localized erythema, pigment changes, capillary dilation, atrophic scarring, and fibrofatty tissue redundancy, which affect the aesthetics to varying degrees. Many parents worry about surgery or laser treatment for their tiny children, but fail to consider that most hemangiomas will expand with age, making it not only more difficult to treat, but also putting the child at greater risk and pain. While waiting for observation, the psychosocial damage caused by hemangiomas, especially those of the head and neck, to growing children is evident. Some patients require laser or plastic surgery at the age of 5 to 15 years to improve their appearance. All of this calls for a re-evaluation of the “wait and see” management strategy for hemangiomas. Two questions often asked about hemangiomas are the degree of degeneration and the duration of degeneration, i.e., will the hemangioma return to normal? How long will this process last? For most cases, the answer to the first question should be that the hemangioma will not completely degenerate to normal. Bowers et al. reported that 50% of hemangiomas complete degeneration by age 5 and 70% by age 12, but the extent of degeneration cannot yet be accurately determined and assessed. In contrast to many scholars who believe that the majority of hemangiomas completely regress, Finn et al. analyzed a large number of cases and concluded the following: 38% of lesions that complete degeneration by age 6 years are left with significant deformities; 80% of hemangiomas that complete degeneration after age 6 years are left with significant deformities that affect aesthetics. Thus, if half of the lesions complete degeneration by age 6, most (59%) will have significant aesthetic deformities. Clinical follow-up reveals that many lesions that have completed degeneration leave behind a thicker fibrofatty tissue, epithelial atrophy, or capillary dilatation in the affected area with varying degrees of deformity. Therefore, the belief that lesions will completely disappear within the first few years of life is erroneous and easily misleading. Superficial hemangiomas replace the papillary layer of the dermis, and the proliferation of lesions may cause epidermal expansion; when hemangiomas proliferate, mast cells may degranulate, leading to dissociation of elastic tissue and skin laxity. Either 1 or 2 of these factors can cause atrophic scarring. Thus, the outcome of superficial hemangioma degeneration may be epithelial atrophy and capillary dilatation; whereas the outcome of subcutaneous hemangioma degeneration may be a legacy of fibrofatty masses and, in the case of compound hemangioma degeneration, a legacy of fibrofatty masses, superficial skin atrophy, and capillary dilatation. The psychosocial impact of this “wait and see” strategy on the child should also be fully considered before deciding to observe the patient for several years without treatment. Some children with facial hemangiomas are unable to attend kindergarten or school and have difficulty getting along with other children because of the deformities they cause. This negative impact is one of the most overlooked aspects of hemangioma treatment. At the stage of personality formation, “wait and see” can cause serious psychosocial trauma to the child, and the personality traits formed will be difficult to change as the child grows up. Children begin to develop a sense of self between 18 and 24 months of age, and from that point on, the presence of a hemangioma can affect them at every important stage of their development. Similarly, the presence of a hemangioma has a marked effect on the child’s relatives, who often feel guilt, low self-esteem, and even disappointment, and exhibit an overprotective consciousness. Finally, in re-evaluating the “wait and see” strategy for hemangioma, we must consider the tremendous advances in basic and clinical research on hemangioma that have been made in recent years. The “wait-and-see” strategy was proposed by Liste in 1938 based on careful clinical observation, because conditions at the time left little choice. In recent years, however, the situation has changed considerably, and the treatment of hemangiomas is no longer monolithic, and efficacy has improved dramatically, with available treatments that can alter the natural course of hemangiomas to near-perfection. We can use flashlamp pumped-dye lasers to selectively destroy the vascular tissue of superficial hemangiomas while preserving normal skin, use certain surgical instruments to reduce or almost eliminate the risk of severe bleeding during hemangioma surgery, and in particular, the serendipitous discovery and successful application of propranolol has revolutionized the treatment of hemangiomas. Current studies have shown that propranolol is effective not only for proliferating hemangiomas, but also for hemangiomas that develop ulcers and for hemangiomas in the regressive phase, and that the adverse effects are mild and generally do not require treatment. In conclusion, the available evidence shows that: 1. only 40% of hemangiomas will completely subside, while the other 60% still need plastic surgery, laser treatment, or a combination of both; 2. it is not possible to accurately predict when hemangiomas will completely subside and to what extent; 3. hemangiomas can cause psychosocial trauma to children and their families, and this trauma is often difficult to heal; 4. the existing hemangioma treatment methods are relatively safe, effective and controllable. Therefore, we should change the previous strategy of “wait and see” treatment of hemangioma and adopt a positive attitude to give appropriate treatment according to the different parts and stages of hemangioma growth, instead of simply “wait and see” and symptomatic treatment.