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MOLLIE 01-21-2008 08:50 PM

7 week old Hemangioma on Forehead
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Hello everyone. I am just starting with this fight. I have a 7 week old daughter that has a "H" on her forehead. Her pediatrician told me that it was not a big deal and it will go away and just "wait and see". I guess I would not be as concerned as I am if I didn't have any experience with the Hemangioma. My cousin who is the same age as I am had one on her lip. Her H started out looking like a little pimple and then grew and grew and grew (it was a little bigger than a golf ball). I am 30 years old now and I still remember how little kids would just stare at her and treat her differently just because of it. She had it removed at age 5 and has a very little scar on her upper lip. For the first 5 weeks of my daughters life the Hemangioma stayed the same. The past two weeks it has raised and is growing at a rapid rate. She has an appointment with a plastic surgeon/ENT here in Fort Worth Texas. I love this man and he and good Lord above have already saved my husbands life (my husband had melanoma in his parotid glands and had a total neck disection twice). I am more than confident with his abilities to treat my daughter. My husband sent him pictures of our daughter and he said that she needed to be seen and treated, the earlier the better. We have an appointment with him first thing on Thursday morning. I am wondering if anyone has an opinion on Steriod Injections. I could be wrong but everything that I have seen so far on this site is that the steriod injections don't seem to work. I am also wondering about laser treatment. Any responses would greatly be appreciated. I have attached photos of my daughter and her Hemangioma.

We just got back from the doctors visit. He took pictures and explained everything to us. He said that it is a compound H and he wants to monitor it and make sure that it doesn't get infected or get a lot bigger and go down into the eye. He said that when he was in medical school and residency when they saw a H they would just say wait and see. Now, he said that they have realized that with most cases especially on the face, these kids will have to go through some type of plastic surgery or laser to revise or remove the left over skin and fatty tissue from the H once it has gone through involution. So that is why the doctors are now starting to do surgery as early as 12 months (when it stops growing completely) to remove the H. They figure that it is better to do surgery younger for a better cosmetic result than to let the child go through the teasing, staring, and unfair treatment and then still have to go some kind of revisement later. He did not want to put her on steriods at this point, he said they just do not have enough research on the long term effects of steriods. He did say if it got too out of control or ulcerated then it might be necessary to start steriods. He also said that the laser can be painful and they usually use sedation with that and again there is not a lot of research on the long term effects like how long it will last or if the color will come back anyways. He wants to see her back in three months or if it grows a lot. He was very understanding and very compassionate. He recommended we waited until she is at least 12 months before removal. I personally have mixed emotions on it and I hope that it is a miracle and it just goes away.

annalbc 01-22-2008 05:32 AM

Hello! Your daughter is beautiful! my daughter Emily had a H on her scalp that started about the size of your daughters and grew to about the size of a ping pong ball....that is the scary thing about hemagiomas, they grow so rapidly. We saw a plastic surgeon in LA, California who opted for surgical removal after the H became ulcerated and infected....We had her surgery when she was 6 1/2 months old, and it was a success...the only drawback is her scar widened a little during healing, which the doc said he could fix when she's older...
basicall the doctors at CHLA's protocol for removal is either large, ulcerating H's or H's that are on the face. I met a few parents of children that had them in the exact spot as your daughters and they opted for removal surgery with fantastic results. Not all docs go that route, but CHLA is fantastic, and world renown. I would look into removal. I dont have any advice on the steroids, although other parents on here have had some success. Good luck! Oh, and i posted a thread with pics a few days ago if you want to look!

Anna, mom to Emily, surgical removal of H at 6 months of age.

aussiechick 01-22-2008 06:04 AM

My daughter had a H on her nasal bridge which was removed in Nov last year. She was 4.5 months old. It was removed by Dr Reinisch who used to be at Childrens Hospital in LA, but now with Cedars Senai. He was fantastic. We are in Australia and we send him photo's to make sure she is on track and everything seems to be going well. Dr R told us that the red bit would eventually fade, could take 3 years or more, but it is the compound part (underneath) that will leave behind fatty tissue and would need removing either now or later. We opted for getting it over and done with now.

Alot of people may not agree with this, but I say if you trust your doctor, I would go for removal rather than steriods. Oral steriods didn't work for us. I am currently pregnant with our second child and if this one has a H I think I will be straight over to see Dr R. These things are just so unpredictable.

But you have to do what is right for you and your family. This is just my opinion. I've attached a few photo's of Ashleigh for you to have a look at.

MOLLIE 01-22-2008 03:09 PM

Thank you Anna and aussiechick. I have been leaning towards doing surgery but we will see if the doctor thinks the same. The only problem is that she is just 7 weeks and only about 11 lbs. This website has been a life line for me. I am so appreciative of all the information on it. Emily and Ashleigh are absolutely beautiful! Thank you again!

annalbc 01-22-2008 05:09 PM

Yah, maybe when she is a little older you can opt for surgery! Good luck, and please keep us posted!

Also, aussie, i had no idea Dr. Reinich moved to cedar senai!!? Any reason why?? Wow, do you know who the head of plastics is at CHLA?? Dr. Hammoudeh is the doc who did Emily's surgery. And great results! Your daughter looks fantastic! :)

lpm 01-22-2008 10:15 PM

I am not certain which posts you looked at that indicated steroid injections don't work. I think that some folks have unrealistic expectations of the injections and oral steroids - if they temporarily halt the growth, they have worked.

My youngest took oral steroids and had an injection. The first dosage of oral steroids wasn't enough, and the doctor increased it. Started at 2.8 mg/kg, then increased to 4.2 mg/kg. Took oral steroids from 2 months to 5.5 months old, then had a steroid injection at 7.5 months. Plastic surgery at 11 months and 2 yrs, 4 months.

If the doctor will do an injection, I would try that first. Also, I have seen a number of cases - some on message boards, and others are kids I know - with hemangiomas in a similar spot to your child's, and they involuted pretty well. No one can say what will happen in a particular case, but I think the injection is worth a try, then wait a while (may also need injections every couple of months for the first year).

Very few doctors would operate at this point - she is just too young for the risk involved. I would try some form of steroids for now, and see how it goes. The fact that you have found a doctor that is willing to see your child is great - even our doctor relatives that tried to help could not get us in for an appointment (I think living in PA has something to do with it).

MOLLIE 01-23-2008 02:45 AM

I am certain that her doctor will do injections first atleast to try to keep it from getting any bigger. My hope is that the H is not to far raised for the pulse dye laser. The pictures that I posted of my little cutie are a week old and the H has raised even more since then. I guess we will find out more on Thursday.

aussiechick 01-23-2008 06:51 AM

annalbc - He was just switching over to Cedars when we had the op done in Nov. Not sure why or who had taken his place at CHLA. We had the op done in a surgerical centre, not cedars. He was fantastic, I just can't believe what a great doctor he was. We were leaving on the Friday after Thanksgiving and he invited us to his house to see Ashleigh post op on Thanksgiving before we flew out the next day. What a wonderful man. And I must say, we met one of his children and his wife and they were all lovely.

lpm 01-23-2008 11:00 AM

If someone will do the injection, I would go for it. Here in PA (we are in Philadelphia area), doctors have little protection from malpractice suits, and so the "wait and see" is their response to almost every ailment. No one here would do the injection - said it was too close to the eye - so we had to go to CA. Also went there for the surgeries, as CHOP wanted to wait until she was four to do surgery.

I don't know too much about how the doctors in Fort Worth area will react to your child's case - our eldest was born there, but we moved when she was four months old.

Laser may help with the red portion, but not with the "bulk." I would try do to both the injection and laser, if the doctor is willing.

MOLLIE 01-24-2008 05:31 PM

I have a question. The doctor we saw said that he wouldn't remove the H in a couple of months because of the risk that after surgery it might grow back and then have to go through surgery again. How many of you have had it out early (before 12-18 months) and had the H grow back? Just curious.....

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