Medical Therapies

Steroids are the mainstay of medical treatment for hemangiomas. Their goal is to slow down the growth of the lesion. Therefore, they are only useful during proliferation – treating an involuting hemangioma with steroids is not useful but unfortunately is commonly done.

Oral or systemic steroids are used for rapidly proliferating lesions in a cosmetically sensitive area or one causing functional impairment.

Carefully Monitored Treatment is Necessary

Lesions are rarely life-threatening. These are always treated with steroids and other medicines. The use of this medication is carefully monitored due to side effects. They are very effective in slowing down the proliferation and buying time for other options, however.

There is evidence that shows that systemic steroids used for the treatment of problematic hemangiomas have short term side effects but no long term complications. These medications must be used at an appropriate dosage for a lengthy period while the child is monitored by a specialist and pediatrician.

Patients must be  carefully weaned off of the steroids and sometimes are restarted at a lower dosage if the hemangioma ‘rebounds’ or begins to grow again.

The closer the patient is to 12 months of age, the less likely the lesion is to continue growing. Intra-lesional injections of steroids, in our opinion, are of benefit in a limited number of cases. The typical lesion which will respond to steroid injections is small, circumscribed and deep. Traditionally, lesions around the eye have been treated with these injections. It is our opinion that surgery is often a better option. In any case, the injections must be repeated several times to see an effect.