Practice Guidelines

American Academy of Pediatrics Releases Report on Infantile Hemangiomas


Am Fam Physician. 2016 Mar 15;93(6):526-527.

Key Points for Practice

• Hemangiomas should be treated in the setting of a life-threatening condition, functional impairment, pain, or bleeding.

• Medical therapy includes oral propranolol, oral corticosteroids, and intralesional steroid injections.

• Delaying elective surgical resection until after infancy allows for involution and better outcomes.

From the AFP Editors

Infantile hemangiomas, the most common tumors of childhood, are vascular neoplasms characterized by abnormal proliferation of endothelial cells and aberrant blood vessel architecture. The incidence of infantile hemangiomas is approximately 5%. Congenital hemangiomas are biologically and behaviorally distinct from infantile hemangiomas because they are fully grown at birth and can be rapidly involuting or noninvoluting. The American Academy of Pediatrics has published this report to provide an update on diagnosing and managing infantile hemangiomas.

Clinical Presentation

Infantile hemangiomas usually appear by four weeks of age and stop enlarging by five months of age. During the involution phase, which is usually complete by four years of age, the lesions flatten, shrink, and fade. Up to 70% of infantile hemangiomas lead to residual skin changes, including telangiectasia, fibrofatty tissue, redundant

Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of Practice Guidelines published in AFP is available at


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Mar 15, 2017

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