Prof. Amir Horev

Dermatology and Venereology Specialist and Pediatric Dermatologist

Hemangioma is a benign lesion composed of blood vessels. It occurs in about 5% of newborns.

It usually appears as a spot on the skin surface that thickens and grows within weeks. Rapid growth, especially in the first months of life, continues at a slower rate during the first year of life, then there is a slowdown in the growth rate and towards the age of two, the lesion begins to regress and regress spontaneously. In most children, the hemangioma will disappear completely, even without treatment, during the first few years of life.

40% of hemangiomas will appear in the head and neck areas, including the eyelids, eye socket and its surroundings. About 10% of cases will require medical intervention, mainly due to a problematic location that may cause disruption in daily functioning, vision, airway obstruction, ulceration, bleeding or due to aesthetic disturbance.

Treatment - a drug from the beta-blocker family (propanolol or atenolol).

This drug will be administered externally as a gel or drops in cases where the hemangioma is superficial, unspread, and without complications.

In more complex cases, the drug will be administered orally for several months. Side effects of oral treatment are rare, but cases of: sleep disturbances, slow heart rate, decreased blood pressure, and decreased blood sugar levels have been reported. In light of this, the drug is administered for the first time under medical supervision and requires several simple tests before and during the start of treatment. Treatment will usually be initiated in a pediatric day care department, or under medical supervision in a clinic.

First visit - partial dose

The first dose of the drug will be given near feeding. Before receiving the drug, pulse and blood pressure should be measured. Two hours after the drug, blood pressure and pulse should be measured again. If all indicators are normal, treatment can be continued at home, while being careful to administer the medicine near feeding and at least four hours before bedtime. After a week, the full dose will be increased.

Second visit (will be performed in certain cases) - increase to full dose under supervision

If the treatment during the week has passed without any unusual effects - the full dose of the medicine will be given and two hours after the administration, the pulse and blood pressure will be measured again. If all indicators are normal, treatment can be continued at home under the supervision of a dermatologist. The duration of treatment is until the lesion disappears or until the age of one to one and a half years. During the administration, it will be necessary to monitor the child's weight changes and adjust the dose of the medicine to the change in weight. If the child has no appetite and cannot eat, for example due to a fever - it is recommended to stop taking the medicine until he resumes eating.

If drowsiness, shortness of breath, tremors or seizures appear during the treatment - treatment should be discontinued and a doctor should be consulted immediately.

Prof. Horev is one of the authors of the guidelines for the treatment of hemangioma in Israel

The Association's guidelines for the treatment of hemangioma