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-   -   Facial Hemangioma-continue treatment or surgery (http://birthmark.org/board/showthread.php?t=5292)

shanarama 03-30-2011 07:15 PM

Facial Hemangioma-continue treatment or surgery
 
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My daughter is 7 1/2 months old and has 3 different kinds of hemangiomas, 1 tiny one on her back, 1 on her hip and 1 large one on her forehead. We sought the help of a dermatologist when she was 10 weeks old because the one on her forehead was huge. Luckily I knew exactly what it was because a good friend's daughter had one in the same spot and it did eventually go away. The dermatologist was not concerned in the least about any of them but because of the rapid growth of the one on her head, we opted for treatments because of the possible damage to the skin by it's stretching. She was started on propranolol and monitored very closely because of her young age and she did beautifully so we've stuck with it. It has shrunk considerably and is getting pretty close to being flat but it's still quite red. At our recent appt, the dr. decided to try timolol also to try to get the redness to subside. He mentioned that some parents opt to just do surgery. At first I was not ready to think about it because she's been fine on the medication and it doesn't bother any of us at all. I am worried that if we stopped the medication, it'll come back. We have another follow up from being on the timolol in 5 weeks and I'd like to collect as much info as possible regarding surgery. The nearest hospital that offers laser treatments that would penetrate deep enough is in Houston so not sure if that would be a starting point before surgery. After thinking that I didn't want to do surgery, I wondered if it would be better than continuing to pump my baby girl full of medicine every day. She's on 2.8mL propranolol 2x a day and the timolol 2 x a day. We tried the steroid for 2 days and all of us were miserable so we quit using it.

Here is a picture of her at 7 1/2 months old.


Thanks for any help!!

missy 03-30-2011 09:30 PM

Hi and welcome!

I'm going to let other parents that have experience with those two drugs answer. I will just say that it's a personal decision and I don't believe at this time that there is a right decision or a wrong decision.

Either way... she's a cutie patootie!

Missy

islabean 04-01-2011 02:10 PM

I am new to the world of hemangiomas so I can't offer you any advice, but I do have a question for you. Did your doctor ever say anything to you about having an ultrasound done to check for internal hemangiomas because she has multiple ones? My daughter has similar ones as yours - 1 on her back, 2 tiny ones on a finger, and 1about the same size as your picture on the top of her head (all congenital ones). My family doctor never said anything about an ultrasound but I'm not sure if that's because he's unaware that internal ones could be present, or if its because she has such a mild case that its not a concern.

shanarama 04-01-2011 02:33 PM

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Thanks for the reply Missy and thank you, I think she's pretty cute too!

@islabean - I asked the doc at our last appt about that and he said that even though she had multiple ones on the outside, the likelihood of more internal would be greater if she had 5 on the outside.

Here's also a picture of what it looked like before we started treating it.

KatieG 04-02-2011 02:36 AM

My daughter had hers removed at 4.5 months (scalp hemangioma) so if you have any questions in regards to that I would be happy to answer!

shanarama 04-09-2011 11:37 PM

Would you do it again? How has the recovery been? Did it come back or does it look like it was never even there? My daughter's is about 1" x 3/4" so I'm worried about the type of incision or scar to bring that much skin together.

Thank you for answering my questions. If you think of others that I should ask the doc, please let me know.

Thanks~

shannonhinz 04-10-2011 02:07 AM

My daughter also had a scalp hemangioma recently removed. We are really happy with the outcome. Recovery was quick and easy and her scar is healing so well.

KatieG 04-10-2011 12:36 PM

Quote:

Originally Posted by shanarama (Post 23042)
Would you do it again? How has the recovery been? Did it come back or does it look like it was never even there? My daughter's is about 1" x 3/4" so I'm worried about the type of incision or scar to bring that much skin together.

Thank you for answering my questions. If you think of others that I should ask the doc, please let me know.

Thanks~

I would do it again in a heartbeat. Her recovery was easy and quick and her hair now covers the scar. You would NEVER know she had something the size of a golf ball on the top of her head.

If you email me I can show you pics.

katiegalvin02@yahoo.com

carley09 04-14-2011 08:54 PM

Have you considered laser treatments. My daughter has a hemi above lip! She was on propranalol for 1st year of her life! Started laser treatments at 13 months, 4 so far, have seen success with it fading the red! Talk to Dr Geronemus on VBF! He will point you in right direction!

Stefany 04-17-2011 02:55 AM

I have 2 daughters with multiple hemangiomas, my youngest's (6mths old) are on her forehead and scalp. We saw an expert (Dr Wagner) on Friday and the recommendations were to start propanol to stop further growth and reduce their size then consider laser therapy if veins/redness remains (she's thinking 1-2 sessions more than likely will do it). It looks like the propanol has been very successful on your daughter, you could be able to avoid surgery by continuing it until the growing/evolution stage (think this is around 12mth or so? not sure though) is over then consider laser therapy if required (if you think Timolol isn't doing anything discuss taking her off it so it's less drugs going in her system). What I think you should consider is which option would give the best end result and discuss this with an expert - surgery would leave a permament scar, would propanol or laser leave less markings? This will really depend on each hemangioma; for example my older daughter (3yrs old) will be having surgery on the hemangioma on her arm (then laser too as the Dr. just wants to remove the very damaged section and laser should take care of the rest- to avoid taking too much skin off), the tissue damage is too great to be resolved with just laser and a surgery scar will be less noticeable than leaving it damaged as it is. However if she had been on propanol back during the hemangioma's growth we might have been able to avoid this.
However it's a very personal decision; this is just my point of view - you have to do what feels right for you. Maybe see another expert for a second opinion? Best of luck!!


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