Out of the Fruit Bowl – Strawberries and Cherries: Hemangiomas Explained

“Infants are often referred to see a dermatologist when the hemangioma is located in a high-risk area.” Dr. Dominey

Andrea M. Dominey, M.D., FAAD

Board-Certified Dermatologist

Many medical conditions are characterized by food-related descriptions. Dermatologic conditions are no exception. Two common vascular lesions seen by dermatologists include strawberry hemangiomas, also called infantile hemangiomas, and cherry angiomas, also known as cherry hemangiomas or senile hemangiomas. 

Strawberry (Infantile) Hemangiomas

Infantile hemangiomas arise in about ten percent of infants. They occur more often in premature infants and females. They may be apparent at birth or appear within the first few weeks of life. Initially they are pale to light pink patches of skin that rapidly darken and begin to form into lump, bumps, or plaques. They grow rapidly during the first six months of life. Between six and twelve months, growth slows and then over the next two to ten years, the hemangioma will usually disappear. Depending on the size, thickness, and location of the hemangioma, it may leave behind small patches of dilated blood vessels, loose, soft, doughy skin, or no visible skin changes at all.

Many hemangiomas come and go on their own without complication and do not need treatment. Other hemangiomas require intervention. These include hemangiomas that grow fast enough to break down and form open sores. They are often located in the folds of the neck, armpits, groin and diaper area. High-risk areas also include the eyes, nose, lips, and ear. It is rare, but large hemangiomas affecting the face, neck, and diaper area have been known to be associated with internal malformations.Infants are often referred by their pediatrician or family doctor to see a dermatologist when the hemangioma is located in a high-risk area such as the head and neck, diaper area, or if the hemangioma is at risk for residual cosmetic abnormalities or is ulcerated.

Fortunately for babies that require intervention, treatment has advanced during the last ten years. Oral and topical beta blockers are helpful in halting the growth of these vascular lesions. Initial monitoring for side effects is done in conjunction with the primary care provider. Length of therapy varies but generally ranges from six to twelve months. Other treatments include oral steroids, laser treatments, interferon injections, and supportive wound care. Fortunately most hemangiomas resolve without complication, with or without treatment. 

Cherry (Senile) Hemangiomas

Unlike strawberry hemangiomas, cherry or senile hemangiomas arise later in life, often after the age of 25-30 years. They are benign and asymptomatic. They appear as small (2-5 mm) pink to bright cherry-red or even purple, smooth surfaced superficial bumps. They appear gradually over months to years. If many appear abruptly, they could potentially be a sign of a more serious condition like internal cancer. If an angioma grows in an area of skin subject to incidental trauma (like rubbing up against clothing) then it may crust and bleed. In this instance, these hemangiomas can be treated to avoid future injury. Additionally, some people request removal for cosmetic reasons. Hemangiomas can be easily treated with laser or electrocautery treatments.

At Advanced Dermatology & Skin Surgery we specialize in diagnosing and treating skin conditions like hemangiomas. Book an appointment online with Dr. Dominey or any of our Dermatology Providers to help address your concerns today. You are also welcome to book your appointment over the phone at 509.456.7414.