Infantile hemangioma is the most common benign tumor in children, and about 60% of them occur in the head and neck. Its typical clinical manifestation is rapid proliferation within 1 year after birth, and then slow regression. 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 self-resolution, the treatment strategy of “wait and see” for hemangiomas has been advocated in the past, allowing them to recede or degenerate naturally. However, a large number of clinical observations have shown that the outcome of natural regression contradicts the “wait and see” treatment strategy, because after the natural regression of hemangioma, local erythema, pigmentation changes, capillary dilation, atrophic scar and fibrofatty tissue redundancy are often left behind, which affect the aesthetics to varying degrees. The psychosocial damage caused by hemangiomas, especially head and neck hemangiomas, to growing children was evident during the waiting period for observation. 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 frequently asked questions about hemangiomas are the degree of degeneration and the duration of degeneration, i.e., will the hemangioma completely return to normal? How long will this process last? Clinical data on the duration of degeneration are well documented. Bowers et al. reported that 50% of hemangiomas complete degeneration by age 5 and 70% by age 12, but the extent of degeneration cannot be accurately determined and assessed. Contrary to the belief of many scholars that the majority of hemangiomas can completely regress, Finn et al. concluded the following by analyzing a large number of cases: 38% of lesions that complete degeneration before the age of 6 years are left with significant deformities; 80% of hemangiomas that complete degeneration after the age of 6 years are left with significant deformities that affect aesthetics. Thus, if half of the lesions complete degeneration by age 6 years, most (59%) will be left with significant aesthetic deformities. Given this, for most cases, the answer to the first question should be that the hemangioma will not completely degenerate to normal. Clinical follow-up has revealed 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 enter kindergartens and schools 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 suggests that: (1) only 40% of hemangiomas will completely regress, while the other 60% still require plastic surgery, laser treatment, or a combination of both; (2) it is not possible to accurately predict when and to what extent hemangiomas will completely regress; (3) hemangiomas can cause psychosocial trauma to the children and their families, which is often difficult to heal; and (4) the existing treatments for hemangiomas 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 different parts and stages of hemangioma growth, instead of simply “wait and see” and symptomatic treatment.