Was your infant born with an infantile hemangioma? An infantile hemangioma (IH) is the most common type of neoplasm, or tumor, identified in childhood. Recent research has found new treatments that are showing promise.
Learn more about IH so you can make the best choices for your baby. Mild, thinner IH lesions may be treated with ointments and lotions available at your compounding pharmacy. Here’s what you should know.
Infantile Hemangioma Are Benign Tumors
An IH is a vascular tumor made up of blood vessels. It is non-cancerous. Terms for IH lesions may include “strawberry birthmark” or “port wine stain.” As many as four to five percent of infants are affected by IH.
According to experts, female infants are three times more likely to be born with IH than male babies. Several other factors may increase the likelihood that a baby will be born with IH, including whether the baby has:
- Caucasian parent(s)
- PHACE syndrome
- Preterm birth
- Older mother
- Twin or multiple-birth siblings
- Breech presentation
Prematurely born infants are especially at risk when they weigh under two pounds at birth. In fact, low birth weight is a major contributor to IH in preterm babies. Every pound of lost expected-weight-at-birth increases the risk of being born with an IH neoplasm by 25 percent.
IH Lesions Are Separate from Other Vascular Abnormalities
Today, medical professionals understand that IH tumors should be described by their cellular makeup and behavior over time rather than the way they look to the naked eye. Vascular anomalies like IH are being studied in depth to both classify neoplasms and develop new treatments on a cellular level for infants born with the tumors.
Understand that a vascular neoplasm is the medical classification for IH lesions on a newborn. Vascular neoplasms are abnormal growths of endothelial cells and blood vessels that are on the surface of body parts at birth. Other childhood tumors are classified as vascular malformations. They involve distortions of the basic structures and development of vessels.
Another type of vascular neoplasm is the congenital hemangioma, which is fully formed and present at birth. Once thought to be a form of IH, a congenital hemangioma is a completely different type of tumor in structure and behavior.
Infantile Hemangiomas Appear Early and May Change
Most cases of IH appear before the infants are one month old. If any growth of the lesions continues, it commonly ends before six months of age. In some cases, the IH will fade and decrease on its own. However, the growths can become disfiguring in some infants.
Your pediatrician cannot tell whether your baby’s IH will grow or shrink. Many physicians will wait to see if changes occur. Help your physician by monitoring your child’s IH (when it’s visible to you) for changes each day.
Take pictures of the lesion every day if that helps you to better note any changes in the size, color and texture of the tumor. If your baby has IH spots on the chin and around the mouth, the breathing may be involved. Keep a close eye on your baby and alert your pediatrician to any airway or breathing issues.
Monitor any IH lesions close to the eyes and ears to ensure the adjacent eye socket or ear canal is not affected by tumor growth. In rare cases, raised IH spots will bleed even when not nicked or cut, but this is usually only a minor issue.
Treatment of IH Lesions Is Determined by Severity
Since there’s no way to know how IH lesions will act, your pediatrician will make recommendations for treatment based on your baby’s age, the growth phase of the lesion and how much of the skin is affected. Other considerations for treatment include:
- Severity and urgency of complications
- Potential for psychosocial problems from appearance
- Parents’ wishes
- Pediatrician’s knowledge of IH
Some of the treatments involve antibiotics, topical painkillers and wound dressings for any bleeding of raised lesions. Steroids have been used in the past, but these sometimes have negative side effects.
Pulsed lasers are used to remove superficial IH lesions that aren’t in a growth phase. Pulsed laser light is not to be used on growing tumors, since scar tissue can result. Surgery is sometimes indicated in severe cases.
When your baby’s IH is superficial and your pediatrician recommends a drug called timolol maleate, your compounding pharmacy is the place to visit. Timolol maleate is a beta-blocker that’s shown efficacy in reducing the size and discoloration of IH lesions in infancy.
One recent study has shown that twice-daily applications of a gel-forming solution of 0.5 percent or 0.1 percent timolol maleate is effective at reducing the severity of lesions. The best results occurred in tumors less than 1 mm in thickness.
The treatment is safe, and babies seem to tolerate it well. Only 3.4 percent of patients in the study had complications, and those were described as mild.
Your compounding pharmacist at Potter’s House Apothecary creates the topical gels or creams you require to address your baby’s everyday skin care and special health issues. We’re happy to answer any additional questions you have about IH and timolol maleate treatment.
