About 3% of infants are born with a convex dark red spot on the face or head, and 10% of babies are formed during the first year of life. This hemangioma is a benign tumor consisting of cells that line the walls of blood vessels. Neoplasm is prone to independent resorption.
Hemangioma in newborns - causes
It is not yet clear why the pathology appears in children. Presumably, hemangioma in newborns on the head is formed in the embryonic period against the background of an abnormal development of the blood vessels. This can be caused by the use of certain medications during pregnancy, the transfer of respiratory-viral and bacterial infections .
There are other possible factors that cause hemangioma in newborns, the reasons are unfavorable environmental conditions or the use of toxic substances by the mother. Recent studies have shown that the benign tumor under consideration can be caused by hormonal disorders, especially if the female is female.
Types of hemangiomas in newborns
Classification of the described neoplasm is based on its morphological features. Hemangioma in children is divided into the following categories:
- simple ( capillary );
- cavernous ( cavernous );
- mixed (combined).
Capillary hemangioma in newborns
This variant of a benign tumor consists of cells lining the internal walls of the superficial blood vessels. A simple hemangioma on the face of a child (or on the head) is located not deeper than the epidermal layer. It has clear boundaries, a hilly-flattened or nodal structure. If you press on the tumor, it will turn pale, then quickly restore its characteristic, purple-bluish, color.
Cavernous hemangioma in newborns
The cavernous form of the disease is located under the skin. It consists of multiple cavities that are filled with blood. Cavernous hemangioma in newborns looks like a cyanotic tubercle with a soft and elastic structure. When pressure is applied to the tumor, it collapses and becomes pale due to the outflow of blood from the cavities. If the baby coughs, tights, or any other stress occurs with increasing pressure, the growth increases in size.
Combined hemangioma in newborns
Mixed variant pathology combines the characteristics of a simple and cavernous tumor. Cavernous-vascular hemangioma in children includes not only cells of capillary walls, but also other tissues:
- nervous;
- connecting;
- lymphoid.
Combined hemangioma in newborns has both a superficial and subcutaneous part. It can progress in different forms:
- angioneuroma;
- hemlymphangioma;
- angiofibroma and others.
Hemangioma - signs
The clinical picture of a benign neoplasm is specific, therefore it is easily diagnosed on examination with a dermatologist. How does hemangioma look like in newborns depends on its type:
- Simple - burgundy bluish tubercle with clear edges and knobby structure, similar to a wart.
- Cavernous - subcutaneous swelling of cyanotic color. It clearly shows what this hemangioma looks like in newborns, the photo below.
- Mixed - a neoplasm, partially located under the skin, visually resembles a capillary shape.
How to distinguish a hemangioma from a birthmark?
It is difficult for parents to independently differentiate the described tumor and other skin defects. Hemangioma of the skin in newborns can resemble a large nevus (birthmark), a birthmark or a wart. To her from these benign neoplasms, you need to put a little pressure on the tubercle. Hemangioma immediately turns pale because of the outflow of blood, but will gradually restore its color. The remaining skin defects will remain the same shade. An additional symptom is that the temperature of the tumor is slightly higher than that of neighboring areas.
Complications of hemangioma in children
Benign neoplasm rarely causes dangerous consequences. In most cases, vascular hemangioma in newborns is painless and does not increase in size. It rarely begins to grow and leads to such complications:
- bleeding against traumatization;
- infection of the tumor, suppuration;
- compression of adjacent tissues and organic structures, violation of their functions;
- ulceration of the neoplasm;
- necrosis (dying) of the skin.
How to treat hemangioma in newborns?
If the baby is diagnosed with a simple form of the disease, the tumor consists only of vascular cells and is not prone to rapid growth, wait-and-see tactics are used. This kind of neoplasm simply carries out constant monitoring. It should be ensured that it does not increase in size or grow very slowly, in proportion to the body of the newborn.
Most capillary hemangiomas dissolve independently as the child grows up. Spontaneous regression occurs gradually. First, in the center of the tumor appear pale areas, close in color to the normal shade of the skin. They expand, reaching the boundaries of the built-up edge. Within a few years the neoplasm becomes ever smaller and finally disappears by 3-7 years.
With cavernous and mixed pathology, radical treatment of hemangioma in children is shown. Operative techniques are prescribed only from the age of 3 months, very rarely surgical intervention is performed in newborns (from 4-5 weeks of life). Depending on the general condition of the body, the type of disease, its size and growth trends, the doctor will advise the optimal variant of the operation:
- sclerosing;
- cryodestruction;
- electrocoagulation;
- laser removal;
- surgical excision.
Sclerotherapy of hemangioma in children
This method of treatment is considered the most sparing, but requires the implementation of several procedures. Sclerotherapy is prescribed when a hemangioma is diagnosed in children under one year, it is located on the mucous membranes, face or parotid region, it has small dimensions. In the presence of a large tumor in newborns, this technique is not suitable because of the risk of scarring and ulcers on the skin.
Sclerotherapy is carried out in stages:
- Preparation. The treated area is wiped off with an antiseptic, alcohol or iodine solution.
- Anesthesia. The skin is lubricated with a local anesthetic.
- Introduction of sclerosant. The active substance is predominantly alcohol (70%) or sodium salicylate (25%). Rarely children are assigned quinine urethane. This drug has high sclerosing abilities, but is too toxic, especially if the baby is a newborn. Injections are made with very thin needles (0.2-0.5 mm). For one manipulation a few injections are carried out, their amount is calculated in accordance with the size of a benign tumor.
- Inflammation. After sclerosing, the vessels become inflamed and thrombosed, replaced with a connective tissue. This process takes 7-10 days, and the inflammation subside.
- Repeat the procedure. Until complete resorption of the neoplasm, 3 to 15 injections are required.
Cryodestruction of hemangioma
The described technique of tumor treatment in newborns is fast and almost painless, but involves some complications. With the help of cryodestruction, hemangioma is removed in children up to a year if the neoplasm is not located on the face. After exposure to liquid nitrogen, a noticeable scar may remain on the skin, and even a convex seal, which will have to be removed by laser resurfacing at a later age.
Procedure of cryodestruction:
- Antiseptic treatment. Hemangioma is wiped off with alcohol or a weak iodine solution.
- Freezing. Through a thin cannula, a jet of liquid nitrogen is supplied to the neoplasm for 3-10 seconds, depending on the size of the tumor.
- Destruction of hemangioma. After cryodestruction, a blister with sterile contents is formed in the defect area. This is a normal process of disappearance of the neoplasm and the death of blood vessels.
- Recovery. Gradually the blister becomes smaller and arbitrarily opened. In its place a dense crust forms.
- Healing. During rehabilitation, it is necessary to treat the wound with drying antiseptic solutions. It is advisable to swaddle the newborn handles or put on mittens so that the kid accidentally does not tear off the crusts. They must fall away on their own.
Electrocoagulation of hemangioma
Exposure to shock is considered one of the most effective and fastest methods of combating a benign tumor. With the help of electrocoagulation, only the cutaneous (simple) hemangioma in newborns is treated, removal of the cavernous or mixed neoplasm is best accomplished by other methods. Advantages of the technique in question is the possibility of eliminating the tumor in just one session, the minimum risk of wound infection and rapid healing.
Electrocoagulation procedure:
- Antiseptic treatment of the skin. Usually alcohol or iodine is used.
- Local anesthesia. Around the place with hemangioma, several injections with an anesthetic are done.
- Removal. By means of a metal nozzle in the form of a loop, the surgeon cauterizes the tumor with an electric current for 1-5 minutes, depending on the size of the defect.
- Rehabilitation. In the treated area, almost immediately a wound is formed, covered with a crust. It can not be removed, the newborn will have to swaddle his arms.
Removal of hemangioma by laser in children
The presented method of therapy is the safest and most effective for tumors located on the surface of the skin of a newborn. Removal of hemangioma in children by laser can be performed at any age, even if the baby is a newborn (from the 1st month). This technology provides the desired result for 1 session, does not lead to the formation of scars and prevents relapses of pathology.
The mechanism of action of the laser is the evaporation and folding of blood in the vessels. Their walls are glued together, and the damaged capillaries are gradually dissolving.
Stages of manipulation:
- Antiseptic treatment of the skin.
- Local anesthesia with injections of anesthetic.
- Irradiation of the tumor with a laser beam.
- Apply a sterile bandage to the healing ointment.
- Skin regeneration. During the rehabilitation period, the newborn's parents should regularly treat the wound with prescribed antiseptics, use healing creams or ointments, do not allow the baby to rip off the crusts.
Surgical removal of hemangioma
The radical approach is used in rare cases, when the new formation is localized not on the skin surface, but in its deep layers. Before removing the hemangioma in children with a scalpel, the surgeon can recommend preparatory procedures or sclerosing to reduce the size of the build-up.
Stages of the operation:
- Anesthesia. Depending on the size of the defect, local or general anesthesia is used.
- Excision. Using a scalpel, the doctor cuts out the hemangioma and a thin layer of healthy tissue around it to prevent relapse.
- Washing, antiseptic treatment of a wound.
- Applying a sterile bandage with antibacterial and healing ointment.
- Rehabilitation period. Recovery can last several weeks. With proper care for the newborn, there are no scars or they are almost invisible.