Hemangioma (Infantile) ICD-10: D18.01

Benign vascular tumor / Infantile condition

Often searched as: red birthmark baby, raised red lump on baby skin, strawberry mark on baby, growing red bump on baby, red skin growth in infant, hemangioma photos, hemangioma treatment, infantile hemangioma…

Clinical urgency level

lowmediumhigh

Systems Affected

skinsubcutaneous tissueinternal organs (in rare segmental or PHACE syndrome cases)

Severity Levels

mild

Small, uncomplicated hemangioma on the trunk or limb, not near critical structures, involuting normally — observation only.

moderate

Hemangioma near the eye, nose, lips, or ear with risk of functional impairment; or ulcerating hemangioma causing pain and wound care challenges — requires medical treatment (propranolol).

severe

Large segmental hemangioma on the face (PHACE syndrome — heart, brain, eye anomalies), airway hemangioma (stridor, breathing difficulty), liver hemangiomatosis (heart failure risk), or multiple cutaneous hemangiomas (>5 — screen for internal hemangiomas) — urgent specialist evaluation required.

Red Flags

Hemangioma near or over the eye (risk of amblyopia / permanent vision loss if untreated)
Hemangioma on the nose, lips, or ear causing distortion or feeding problems
Stridor (noisy breathing) in an infant with a facial hemangioma — possible airway involvement
Ulceration with significant pain, bleeding, or signs of infection
More than 5 small hemangiomas on the skin — screen for liver or internal hemangiomas
Large hemangioma on the face (>5cm) with segmental distribution — possible PHACE syndrome workup needed

Clinical Presentation

Infantile hemangioma — bright red strawberry mark on the cheek of an infant

Source: Wikimedia Commons (CC BY-SA 3.0 )

Hemangioma image gallery — DermNet NZ

View gallery on DermNet NZ (image gallery reference)

When to See a Doctor

See a pediatrician or pediatric dermatologist if your baby's hemangioma is near the eye, on the nose or lips, ulcerating, or growing rapidly. Hemangiomas near critical structures need early treatment with propranolol (oral) to prevent permanent complications. Most hemangiomas on the trunk or limbs away from critical areas can be monitored.

Differential Diagnosis

Port wine stain (vascular malformation — present at birth, doesn't grow or involute)
Pyogenic granuloma (fast-growing, bleeds easily — usually in older children)
Venous malformation (soft, compressible, bluish — present at birth)
Kaposiform hemangioendothelioma (KHE — rare, aggressive, can cause thrombocytopenia)
Tufted angioma
Naevus flammeus (salmon patch / stork bite — fades in first year)

Comorbidities

PHACE syndrome (large facial hemangioma + posterior fossa brain anomalies + arterial/cardiac/eye anomalies)
LUMBAR syndrome (lumbosacral hemangioma + spinal anomalies)
Liver hemangiomatosis (multiple liver lesions — hypothyroidism and heart failure risk)
Ulceration (most common complication — painful, infection-prone)

Prognosis

The vast majority of infantile hemangiomas follow a predictable course: rapid growth in the first 3–6 months of life, plateau, then slow involution beginning around age 1. By age 5, ~50% have involuted; by age 10, ~90%. However, residual fibrofatty tissue or skin changes may remain after involution. Propranolol (oral) is the first-line treatment for complicated or high-risk hemangiomas, achieving dramatic results when started early (first weeks to months of life). Timely treatment prevents the irreversible complications — amblyopia, airway compromise, permanent disfigurement.

Detailed Overview

Causes, Symptoms, and When to Take Action Hemangioma is a common benign vascular tumor, most often appearing in infancy. These growths are made up of an abnormal buildup of blood vessels and typically develop shortly after birth. While they may initially appear alarming, hemangiomas are usually harmless and tend to resolve on their own over time. How It Looks Texture: Soft, compressible, and may feel warm Color: Bright red (superficial) or bluish-purple (deeper types) Shape: Round or oval, often raised above the skin Location: Most common on the face, scalp, chest, or back Why Does It Appear? More common in premature babies, girls, low birth weight infants, and those from multiple pregnancies. Thought to arise from localized proliferation of endothelial cells. Should You Be Concerned? Medical attention is advised if the lesion bleeds, ulcerates, or becomes painful; interferes with vital functions (eyes, nose, mouth, airway); or shows rapid growth. Can You Prevent It? There is no known way to prevent hemangiomas. Regular checkups during infancy and early identification help in managing any that may pose a risk. 👉 How Piel AI Can Help Piel AI provides a way to track changes in vascular lesions over time, helping document growth, color, and shape changes that may need evaluation. Summary Hemangiomas are benign vascular tumors common in infancy. They typically appear as red or bluish raised lesions. Most resolve on their own without treatment. Medical attention may be needed if complications arise.

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