Vascular Birthmarks Foundation Forum - View Single Post - Diaper Area Hemangioma
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Old 05-17-2010, 10:13 PM
Kirstyloo Kirstyloo is offline
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Join Date: May 2010
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I know how hard this is! We were you about 3 weeks ago, but the good news is that my daughter's spot appears to be healing. Here is our story and what we found worked for us.

My 9 mo daughter has a half dollar sized hemangioma on her right buttocks. Luckly, it is not on the anus or in the mucosal area. This hemangioma like the other 3 on her body had started to regress. As commonly happens it became ulcerated during the regression. Despite seeing her ped and getting an antiobiotic cream, it became bigger. One week after it opened up, we had an appointment with a plastic surgeon who used laser treatment on it. A week later, it was even deeper and more painful. At its worst, the ulcer was larger than a quarter and about centimeter deep. It didn’t seem as though anything that we did helped, and it was horribly painful for my daughter.

We were frustrated because the doctors didn’t give us a wound management plan. We took what little advice we got from our Ped and the Plastic surgeon and here is what we came up with:
1. We changed her diaper every 2 hours religiously while she was awake. We didn't care if she didn't seem wet. We also changed her diaper ASAP after stool. She is 9 months old so we could let her sleep on her stomach during the night so the pee would drain forward. If she were younger, we might not have made that choice because of the potential of SIDS.
2. We also changed our diaper wipes. We found some without alcohol to use for general diaper cleaning. We’ve also been using a wet wash cloth to clean the wound. We send a pack of 4-5 wet wash cloths to daycare in a ziplock with the instruction to dab/pat her ulcer at each diaper change. They use the wipes for all other areas.
3. Our plastic surgeon gave us a prescription for Lidocaine jelly (the jelly lasts longer on the skin than the cream or solution). We apply a very thin amount of Lidocaine 2% to the sore after diaper changes. Within 2-5 minutes, it appears to dramatically decrease her pain; however, you need to be very careful not use too much as it can cause respiratory and cardiac problems. Our plastic surgeon didn’t mention this when it was prescribed. Only when I called back a week later and talked to his nurse was I informed of the drugs serious risks. She seemed a bit shook up as to how we were using it originally.
4. We applied a prescription antibiotic cream 3x day and after stool. From what I’ve read, antibiotic cream can irritate the sore so we've tried to limit its use.
5. Our Ped indicated that we should apply Aquafor to the site to provide a water barrier; however, cream didn’t stay there well enough between diaper changes. When I asked the Plastic Surgeon what to do, he recommended using a nonstick pad without tape to cover the site, but he didn't mention Aquafor. Each in isolation wasn’t working as they didn’t last or stay stuck. So we combined the advice. We put a heavy layer of Aquafor on the pad before applying it. If it is changed every 2 hours while the child is awake, it appears to provide a pretty good barrier. It seems to protect about 90% of the time.
6. We then applied a diaper ointment with zinc oxide to the rest of the traditional diaper area. I realized that she was developing some irritation in other areas. I think that this was because we weren't able to clean her off quite as well as usual because of how traumatized she was during diaper changes. Some websites recommended zinc oxide for ulcerated lesions so we applied it liberally every where else except for the ulcerated area.
7. We had her sit/play in a warm bath for 5-10 minutes each day and then we gently patted the area with a dry towel. Do no rub as it can pull off the new skin.
8. We had her “air dry” bottom up for 10-40 minutes each day on dry towels. Personally, I found this to be a really great mommy and baby time.

I think that the key for us was the Aquafor and the pad. It did a pretty good job of keeping stool and urine off of her sore. Even without the tape, the Aquafor did a pretty good job of holding the pad in place and urine and poop away.

I’m so happy to say that my daughter’s ulcer is only about 1/3 of the size it was 10 days ago, and it is much shallower. She hasn’t cried because of it for about 4 days. I know that we aren't out of the woods, but I do think that we're moving the right direction.

Best of luck! I really do know how hard it is when your child is in so much pain, and you can’t stop it.

PS - If you do get laser treatment for your child, make sure that they put a pain killer on it while you are in the office! The surgeon gave us a prescription for the numbing med, but the first pharmacy I went to didn't have it. She screamed herself to sleep as we drove frantically around. I do wish the doc had simply pulled out a tube and used it. I can't imagine that he doesn't have tube of it somewhere in his office for use before or after a procedure. We will have a discussion about this during our followup appointment along with him not warning us about the dangers of the drug.

Last edited by Kirstyloo : 05-18-2010 at 11:58 PM.
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