How to differentiate red birthmarks from hemangiomas

Nov 06, 2025 Source: Cainiu Health

Dr. Liu Wenmin

Introduction

Distinctions between red birthmarks and hemangiomas generally include intrinsic characteristics, appearance, growth patterns, response to pressure, and risk of complications. Intrinsic characteristics: Red birthmarks are mostly due to skin pigmentation or vascular malformations, representing benign and stable skin features; hemangiomas are benign tumors caused by abnormal proliferation of vascular endothelial cells, exhibiting phases of growth, stabilization, and regression.

Red birthmarks and hemangiomas can generally be differentiated based on several aspects, including intrinsic characteristics, appearance, growth patterns, response to pressure, and risk of complications. The specific analysis is as follows:

1. Intrinsic characteristics: Red birthmarks are mostly caused by skin pigmentation or vascular malformations and are benign, stable skin features. Hemangiomas, however, are benign tumors resulting from abnormal proliferation of vascular endothelial cells, and typically go through phases of proliferation, stabilization, and regression.

2. Appearance: Red birthmarks usually appear light red or dark red, with irregular shapes, poorly defined borders, and a surface level with the surrounding skin. Hemangiomas are bright red or deep red, more regular in shape, with clear boundaries, often raised, and some may have a lobulated surface.

3. Growth pattern: Red birthmarks are present at birth or appear shortly thereafter, and remain stable in size and color over time without spontaneous regression. Hemangiomas typically emerge within weeks after birth, grow rapidly during the first 3–6 months, and may gradually regress spontaneously starting from 1–2 years of age.

4. Response to pressure: When pressed, red birthmarks show little or no color change, or may slightly fade. In contrast, hemangiomas significantly blanch to near-normal skin color upon pressure and quickly return to their bright red appearance once pressure is released.

5. Risk of complications: Red birthmarks rarely cause complications and mainly pose cosmetic concerns. Hemangiomas, especially those located in critical areas, may compress surrounding tissues and carry risks of bleeding, infection, or ulceration.

Upon discovering any abnormal red area on the skin, it is recommended to seek timely evaluation from a dermatologist or pediatrician for accurate diagnosis through professional examination. If diagnosed as a hemangioma, regular monitoring of its growth should be conducted according to medical advice, and friction or trauma to the affected area should be avoided.

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Is timolol maleate eye drops effective for treating hemangioma?

This approach is effective mainly for superficial, small-sized infantile hemangiomas. The medication can penetrate locally, inhibit vascular proliferation within the hemangioma, slow down lesion growth, and even promote gradual regression. These hemangiomas are typically located in the superficial skin layers, allowing the drug to fully reach and act on the lesion. This treatment is commonly used in clinical practice as a standard intervention for such hemangiomas.

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What are the consequences of not treating a child's hemangioma?

The consequences of untreated infantile hemangiomas may generally include effects on physical appearance development, increased risk of infection and ulceration, compression of surrounding tissues, bleeding risks, and impaired functional development. Impact on appearance: If a hemangioma develops in exposed areas such as the face or neck, it may gradually enlarge with age, deepen in color, or become raised, potentially leading to permanent pigmentation or scarring, thus affecting the child's physical appearance.