A strawberry hemangioma is a type of birthmark that is caused by an overgrowth of blood vessels in the skin. This type of birthmark is also known as a capillary hemangioma, or simply a hemangioma. Strawberry hemangiomas are the most common type of hemangioma and are usually present at birth or develop within the first few weeks of life. They are most commonly found on the face, scalp, chest, or back.

There are two main types of strawberry hemangiomas: superficial and deep. Superficial hemangiomas are located closer to the surface of the skin and are composed of dilated blood vessels. Deep hemangiomas are located deeper in the skin and are composed of both dilated blood vessels and fibrous tissue.

Superficial Strawberry Hemangioma: This type of hemangioma is also known as capillary hemangioma. It is the most common type of hemangioma and is characterized by bright red, raised, and sometimes bumpy skin. Superficial hemangiomas are usually small in size and are located close to the surface of the skin. They can appear anywhere on the body but are most commonly found on the face, scalp, chest, or back.

Deep Strawberry Hemangioma: This type of hemangioma is also known as a cavernous hemangioma. It is less common than superficial hemangioma and is characterized by a purplish-blue or red bump that is located deeper in the skin. Deep hemangiomas are usually larger in size than superficial hemangiomas and can be more difficult to treat. They can cause structural changes in the skin, including scarring and disfigurement.

Causes

Although the exact cause of strawberry hemangiomas is not known, there are several theories as to why they occur:

1. Genetic predisposition: Some researchers believe that genetics may play a role in the development of strawberry hemangiomas.
2. Hormonal changes: Hormonal changes during pregnancy may cause blood vessels to cluster together, resulting in a strawberry hemangioma.
3. Immune system problems: A weakened immune system may be a factor in the development of strawberry hemangiomas.
4. Environmental factors: Exposure to certain environmental toxins or chemicals may increase the risk of developing a strawberry hemangioma.
5. Blood flow problems: Abnormal blood flow or circulation problems may contribute to the formation of strawberry hemangiomas.
6. Infections: Certain infections during pregnancy or after birth may increase the risk of developing a strawberry hemangioma.
7. Inflammation: Inflammation in the skin may trigger the formation of a strawberry hemangioma.
8. Trauma: Trauma to the skin during pregnancy or after birth may lead to the development of a strawberry hemangioma.
9. Medications: Certain medications taken during pregnancy may increase the risk of developing a strawberry hemangioma.
10. Nutritional deficiencies: Nutritional deficiencies during pregnancy or after birth may increase the risk of developing a strawberry hemangioma.
11. Vitamin A deficiency: A deficiency in Vitamin A may increase the risk of developing a strawberry hemangioma.
12. Vitamin C deficiency: A deficiency in Vitamin C may increase the risk of developing a strawberry hemangioma.
13. Vitamin E deficiency: A deficiency in Vitamin E may increase the risk of developing a strawberry hemangioma.
14. Zinc deficiency: A deficiency in Zinc may increase the risk of developing a strawberry hemangioma.
15. Iron deficiency: A deficiency in Iron may increase the risk of developing a strawberry hemangioma.
16. Folate deficiency: A deficiency in Folate may increase the risk of developing a strawberry hemangioma.
17. Maternal age: Women who are older when they have a baby may have a higher risk of their child developing a strawberry hemangioma.
18. Maternal health: Women who have certain health conditions, such as high blood pressure or diabetes, may have a higher risk of their child developing a strawberry hemangioma.
19. Multiple pregnancies: Women who have multiple pregnancies may have a higher risk of their child developing a strawberry hemangioma.
20. Family history: Children who have a family history of strawberry hemangiomas may have a higher risk of developing one themselves.

It’s important to note that many of these theories are not well supported by scientific evidence and more research is needed to fully understand the causes of strawberry hemangiomas. Additionally, many children with strawberry hemangiomas have no known risk factors, so it’s likely that multiple factors are involved in their development

Symptoms

Symptoms of strawberry hemangioma:

1. Bright red color: Strawberry hemangiomas are often a bright, vibrant red color, making them easily noticeable.
2. Raised, bumpy appearance: The tumors are often raised and bumpy, giving them a distinct look that sets them apart from other types of birthmarks.
3. Rapid growth: Strawberry hemangiomas often grow rapidly, especially in the first few months of life.
4. Soft or spongy texture: The tumors are often soft and spongy to the touch, making them different from other types of skin growths.
5. Round or irregular shape: Strawberry hemangiomas can be round or have an irregular shape.
6. Varying size: The size of the tumors can vary, ranging from a small dot to several inches in diameter.
7. Itching: Some people with strawberry hemangiomas may experience itching, which can be uncomfortable.
8. Bleeding: In some cases, the tumors may bleed if they are scraped or injured.
9. Pain: Some people with strawberry hemangiomas may experience pain or discomfort, especially if the tumors are located in an area that rubs against clothing or other objects.
10. Scarring: In some cases, strawberry hemangiomas can cause scarring if they are left untreated or if they are treated improperly.
11. Changes in skin color: The skin around the tumors may change color, becoming lighter or darker than the surrounding skin.
12. Ulceration: In some cases, the tumors may develop ulcerations, which are open sores on the skin.
13. Increased sensitivity: The skin around the tumors may be more sensitive to touch or pressure.
14. Distortion of surrounding tissue: The tumors can sometimes cause distortion of the surrounding tissue, making it difficult to move or use the affected area.
15. Disfigurement: In severe cases, strawberry hemangiomas can cause disfigurement, altering the appearance of the affected area.
16. Interference with vision: If the tumors are located near the eyes, they can interfere with vision.
17. Interference with breathing: If the tumors are located near the airway, they can interfere with breathing.
18. Interference with feeding: If the tumors are located in the mouth or throat, they can interfere with feeding.
19. Psychological distress: Having a visible birthmark can be emotionally distressing for some people, and this can be especially true for children with strawberry hemangiomas.
20. Increased risk of infection: In some cases, the tumors can increase the risk of infection if they become ulcerated or if the skin around them is damaged.

It’s important to remember that not all people with strawberry hemangiomas will experience all of these symptoms, and the severity of the symptoms can vary from person to person. If you have concerns about a birthmark or skin growth, it’s best to consult a healthcare provider for an evaluation.

Diagnosis

Here is a brief overview of some common tests and diagnoses that may be used to evaluate strawberry hemangiomas:

1. Physical examination: A physical examination of the affected area is the first step in diagnosing a strawberry hemangioma. The doctor will look for characteristic signs such as the color, texture, and location of the lesion.
2. Dermatoscopy: Dermatoscopy is a non-invasive technique that uses a specialized device to examine the skin in detail. This technique can help differentiate strawberry hemangiomas from other types of birthmarks and skin lesions.
3. Ultrasound: An ultrasound is a diagnostic imaging test that uses high-frequency sound waves to produce images of the internal structures of the body. Ultrasound can be used to evaluate the size, location, and depth of the lesion, and to determine if it is a hemangioma or a different type of lesion.
4. Magnetic resonance imaging (MRI): MRI is a diagnostic imaging test that uses a powerful magnetic field, radio waves, and a computer to produce detailed images of the body’s internal structures. MRI can be used to evaluate the size and location of the lesion and to determine if it is a hemangioma or a different type of lesion.
5. Biopsy: A biopsy is a procedure in which a small sample of tissue is removed from the lesion for laboratory analysis. A biopsy can confirm the diagnosis of a strawberry hemangioma and rule out other conditions.
6. Blood tests: Blood tests may be performed to rule out other conditions that can cause similar symptoms. These tests may include a complete blood count (CBC), coagulation studies, and liver function tests.
7. Angiogram: An angiogram is a diagnostic test that uses X-rays and a special dye to produce images of the blood vessels. An angiogram can be used to evaluate the blood flow to the lesion and to determine if it is a hemangioma or a different type of lesion.
8. Photodynamic therapy (PDT): Photodynamic therapy is a treatment that uses a special light and a photosensitizing agent to destroy abnormal blood vessels. PDT may be used to treat larger or more persistent hemangiomas.

Treatment

Treatment options for strawberry hemangiomas:

1. Observation: In some cases, a strawberry hemangioma may not require any treatment and may simply be observed. This is especially true for small or asymptomatic hemangiomas.
2. Topical Corticosteroids: Topical corticosteroids may be used to reduce the size and redness of a strawberry hemangioma. They work by reducing inflammation and blood flow to the affected area.
3. Topical Timolol: Topical timolol is a medication that can be applied directly to the hemangioma to reduce its size and redness. It works by blocking the growth of new blood vessels in the affected area.
4. Intralesional Corticosteroids: Intralesional corticosteroids are injected directly into the hemangioma to reduce its size. This is typically done by a dermatologist or plastic surgeon.
5. Laser Therapy: Laser therapy, also known as laser ablation, can be used to reduce the size and redness of a strawberry hemangioma. The laser works by destroying the blood vessels that make up the hemangioma.
6. Cryotherapy: Cryotherapy is a treatment that involves freezing the hemangioma with liquid nitrogen. This can cause the blood vessels in the hemangioma to shrink and eventually disappear.
7. Electrodessication and Curettage (ED&C): ED&C is a surgical procedure that involves using an electric current to destroy the hemangioma and then scraping away the dead tissue.
8. Sclerotherapy: Sclerotherapy is a procedure that involves injecting a solution into the hemangioma to shrink its blood vessels. The solution causes the blood vessels to collapse and eventually disappear.
9. Excision: Excision is a surgical procedure that involves removing the hemangioma and stitching the skin back together. This is typically done for larger hemangiomas that are causing discomfort or affecting function.
10. Steroid Pulses: Steroid pulses are high-dose injections of corticosteroids that are given over a short period of time. They can help to reduce the size of a strawberry hemangioma.
11. Interferon: Interferon is a type of protein that can be used to treat strawberry hemangiomas. It works by stimulating the immune system to attack the hemangioma.
12. Propranolol: Propranolol is a medication that can be used to treat strawberry hemangiomas. It works by reducing the blood flow to the affected area, which can help to shrink the hemangioma.
13. Vincristine: Vincristine is a chemotherapy drug that can be used to treat strawberry hemangiomas. It works by stopping the growth of new blood vessels in the affected area.
14. Imiquimod: Imiquimod is a topical cream that can be used to treat strawberry hemangiomas. It works by boosting the immune system’s response to the hemangioma, which can help to shrink it.
15. Topical Tacrolimus: Tacrolimus is a topical cream that can be used to treat strawberry hemang