Many skin diseases and changes lead to the formation of nodules and red skin areas. It is not clear to those affected which type of skin change is involved. The symptoms and the visible changes are similar in many cases. At first glance, a hemangioma, for example, appears to be a skin change of a malignant nature, a kind of “red mole”. This is because skin cancer also typically manifests itself with altered moles. Dermatologist Dr. Titus Brinker is our expert for hemangiomas and clarifies all questions regarding the development of cherry hemangiomas, the course of the disease, diagnosis and therapy as well as treatment and therapy options. In addition, individual consultation with dermatologists from Germany is possible via our homepage.
Cherry hemangiomas often look like a “red mole”.
What exactly is a hemangioma?
A hemangioma described in this way is generally defined as a benign tumour. It is usually visible by red spots and partly also by nodules. Alternatively, these phenomena on the skin are also called cherry hemangiomas or ruby spots. The inner layer of the affected blood vessels multiplies in excessive numbers. Doctors also refer to this as an embryonic tumour.
This means that about 75 percent of hemangiomas are already present at birth. But the cherry hemangiomas can also develop in adulthood. Such hemangiomas develop in adults preferably in the middle phase of life. Doctors call this a tardic hemangioma. However, hemangiomas do not really represent a degeneration. It is formed by dilated blood vessels, whereby physicians classify the cherry hemangiomas as harmless.
The cherry hemangiomas increase and multiply over time
In terms of frequency, there are no differences between women and men in the occurrence of these hemangiomas: hemangiomas generally occur equally in both sexes. Once a hemangioma is formed, it persists permanently. In addition, it has been shown in practice that cherry hemangiomas often increase in size and multiply over time. Initially, a hemangioma always has clear and narrow limits.
So the initial stage is always light red patches that are only a few millimeters in size. If the blood vessels expand even more over time, soft nodules form which change from light to dark red. The reddish nodules and spots can also form on the face. However, there is no pain in the affected areas. Hemangiomas can generally be removed – for cosmetic reasons, for example – using laser technology or similar methods.
An incident light microscope makes a precise diagnosis possible
However, skin changes of this kind should always be examined thoroughly by a physician. For those affected it is not clear whether it is a benign or a malignant skin change. Tardic haemangioma is similar to the appearance of skin cancer. In order to be able to make a precise diagnosis, vascular specialists or phlebologists use an incident light microscope. Anyone suffering from hemangioma should always make sure that the cherry hemangiomas are not damaged.
The actual knots or knots under the skin are vascular loops filled with blood. In many cases the cherry hemangiomas show impaired wound healing. If a hemangioma is particularly sensitive, bleeding can easily occur in this area. As a result, bacteria can penetrate the affected areas of the skin with the hemangioma. Experts such as Dr. Titus Brinker recommend laser treatment for sensitive tardic haemangiomas.
Cherry hemangiomas in children are not uncommon
The corresponding surveys already reveal hemangiomas in about four to five percent of newborns in Germany. The head as well as the neck area turned out to be the most frequent localization. Basically, a distinction is made between two different forms of these skin changes in children. One is capillary hemangioma, also known as strawberry hemangioma. Cherry hemangiomas of this type consist of many small blood vessels, the so-called capillaries. A hemangioma of this type is localized in the skin and mouth as well as in the liver and kidneys. As a rule, these hemangiomas then fade again until they are five years old.
Difference between capillary and cavernous hemangiomas
In some cases, however, the capillary hemangioma turns into the so-called cavernous hemangioma, which is alternatively also called port wine spot. This form occurs primarily in the skin, in organs and also in the central nervous system. In contrast to capillary haemangioma, the cherry hemangiomas consist of larger vessels, which in many cases are filled with plenty of blood. Here there is the danger that blood clots form.
In technical terminology, these blood clots are called thrombi. A spontaneous regression of such a cavernous hemangioma could not be observed so far. In addition, medicine has not yet been able to clarify explicitly which causes are responsible for the development of childhood hemangiomas. In the case of cherry haemangiomas, on the other hand, the development is clear: the cherry hemangiomas are formed by the dilatation of near-surface vessels.
Diagnosis and symptoms of hemangiomas
As already described above, a hemangioma can be easily recognized with the naked eye due to the clearly visible red coloration of the skin. There are no known symptoms or accompanying symptoms of any noteworthy nature, but in rare cases there may be pain when pressure is exerted on the cherry hemangiomas. For a precise diagnosis, doctors express the respective vascular loops, for example with a glass spartel. If pressure is exerted on the affected skin areas, the blood vessels empty.
This causes the red coloration to fade, which then returns as the pressure decreases. In cases of doubt, a dermatoscope is always a valuable aid in making a reliable and precise diagnosis. After localization and diagnosis, the attending physician always waits to see how the hemangioma develops.
Typical development of hemangiomas
The comparatively high regression rate of the cherry hemangiomas often leads to spontaneous healing. Typical for this is the following development:
1. growth phase.
2. standstill phase.
3. regression phase.
The following applies: The smaller the cherry hemangiomas are, the greater the chance that a hemangioma will heal completely. If the affected person suffers from a larger hemangioma, this often leads to skin discoloration and scars. In addition, a bald spot can remain after spontaneous healing in areas with hair growth. Therapies usually only take place when complications such as bleeding or thrombosis as well as exulcerations occur.
Integration of drugs into hemangioma therapy
The cherry hemangiomas are also treated with medication in the course of an appropriate therapy. Three different medications are available for drug therapy of hemangioma: propranolol, glucocorticoids and interferon-alpha..
- Propranolol: The drug has been used for hemangioma therapy since 2008. This drug was originally developed for patients with cardiovascular diseases. But propranolol is also used for haemangioma requiring therapy or treatment if the lase ablation or kyrotherapy (here: treatment with cold or ice) has not brought the desired therapeutic success. In such a case, a doctor can then prescribe propranolol to his patient, which is always only used in a comparatively low dosage.
- Glucocorticoids: This active ingredient is a component of various ointments and creams which, when applied to the affected areas of the skin, reduce or even completely eliminate the cherry hemangiomas.
- Interferon-alpha: This drug is mainly used in cancer therapy. In particularly persistent cases, however, doctors also use the drug to heal hemangiomas.
Hemangiomas can also be surgically removed
In addition to the medicinal treatment of cherry hemangiomas, various procedures are also available in which the existing cherry hemangiomas or the respective hemangiomas are specifically removed during small operations. In particular, the following three procedures are in focus:
- Surgical excision: This method is rarely used. This is mainly due to the fact that the hemangioma is cut out of the skin during this surgical procedure. This can leave cosmetically unattractive scars.
- Kyrotherapy: In this procedure cold is used to specifically kill the cells of a flat hemangioma. Surgical tools are not used at all. Thus no scars develop with the Kyrotherapie also.
- Laser ablation: Laser ablation is the right solution for large and deep skin lesions rather than superficial flat hemangiomas. The laser ablation removes or reduces the respective hemangioma.
- An individual consultation is possible via our home page.
Individual consultation with a dermatologist from Germany
Via our homepage you can send photos of your skin problem to a dermatologist from Germany with at least 10 years of practical experience. In this way, you will quickly, anonymously and inexpensively receive a professional assessment of what your skin change is. You will also receive a recommendation on what you should do about your skin problem.