Because most hemangiomas regress completely on their own, there is usually no treatment. The final result of involution is often more cosmetically acceptable than if the hemangioma has been removed surgically. The decision to treat a hemangioma is based on several factors including location, size, and complications.
The risks and benefits of treatment should be weighed carefully. Despite parental pressure, treatment is reserved for hemangiomas that are life-threatening, that distort or obstruct important structures, and that ulcerate.
Oral corticosteroids are first-line therapy for hemangiomas that require treatment. They are administered at high doses for 4 to 6 weeks and are gradually tapered off. If the medication is discontinued too soon, the hemangioma can regrow. Not all hemangiomas respond to this therapy, about one-third respond rapidly, but the rest respond minimally or not at all.
Corticosteroids can be injected directly into the tumor, usually once a month for several months. This may help resolve ulcerated hemangiomas.
Interferon-alpha is a possible treatment for a hemangioma that does not respond to other therapies. It is reserved for those with a life-threatening lesion that obstructs a vital structure. Side effects can be experienced with this medication, and they should be thoroughly explained to, and understood by the child and parents before using this therapy.
Lasers can be used to treat hemangiomas, but their effectiveness has not been established. Furthermore, laser treatment is not effective for the deeper components of lesions. Laser therapy can successfully treat residual blood vessels after involution and is helpful in reducing the pain and healing time of ulcerated lesions.
Hemangiomas can be surgically removed (excised), although surgery is reserved for critical cases and for those in which the surgical scar is more cosmetically acceptable than that left by natural regression.
There is no known method for preventing hemangiomas. Infections in ulcerated lesions can be avoided with meticulous care.