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Q: My two-month-old daughter has a hemangioma on her lower lip and on the skin below her lip. One doctor told me to take her to a plastic surgeon. Another told me that it will disappear on its own and I should do nothing. Which advice is correct?
A: Hemangiomas are very common in babies, usually noticed within the first few weeks of life. They tend to occur more often in girls, appearing anywhere on the body (more than half are on the head and neck region) in as many as one out of every 20 to 25 babies. Typically, hemangiomas represent clusters of blood vessels generally close to the surface of the skin that are raised and red or purplish in color. Others can begin in the deeper layers of the skin. Hemangiomas do tend to get larger during the first year of life and then begin to shrink (involute) over the next few years. A hemangioma's color usually has disappeared by five to seven years of age.
Although hemangiomas can be cosmetically worrisome to parents, concern should initially revolve around whether they are quite large or whether their size and location are causing secondary effects. For example, some children have had them very near their windpipe, resulting in breathing difficulty. Of course, these would warrant immediate attention. Sometimes hemangiomas can be associated with, or located near, other malformations.
Be reassured that most hemangiomas, like the one you described, do not require evaluation by a specialist who deals with these types of vascular growths. They can more easily be observed by your child's pediatrician and referral made if the diagnosis is in question, if the hemangiomas are medically problematic, or if you are in need of further reassurance.
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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.