Author: Dr. Vikram Chauhan

ABSTRACT

Hemangiomas or infantile hemangiomas are the non cancerous growth of the blood vessels which are found on the skin. The blood vessels are the components of the circulatory system which transports the blood throughout the body. It transports cells, nutrients and oxygen to the tissues of the body, sustains life as body tissues rely on functions. There are usually five types of blood vessels- arteries (which carry blood away from heart), The arterioles, Capillaries (where exchange of water and chemicals occurs), The venules, Veins (which carry blood from capillaries back towards the heart). Some structures such as cartilage, cornea of eye, lens and epithelium do not contain blood vessels and hence are avascular. The arteries and veins have three layers- The inner layer (is the thinnest layer), middle layer (thickest layer in arteries) and the outer layer (thickest layer in veins). Blood vessels connect to form a diffuse vascular supply known as anastomosis. Main function is to transport blood throughout the circulatory system. The arteries transport oxygenated blood from lungs to body and veins transport deoxygenated blood from body to lungs. Usually blood is propelled through the arteries and arterioles through pressure which is generated by heartbeat. In this article we are going to discuss its causes, treatment, and ayurvedic management of Capillary Hemangiomas.

INTRODUCTION

Hemangioma is a benign vascular tumor which is derived from the blood vessels cells, and most commonly seen in infants so known as infantile hemangioma. It is also known as the Strawberry mark which is present at the birth time or usually in the first weeks of life. It can occur anywhere in the body such as on the face, scalp, chest and back. Hemangioma looks like a rubbery lump which is made up of extra blood vessels in the part of the skin. They are usually harmless and they tend to resolve on their own. It is made up of rapidly dividing cells of the blood vessels (endothelial cells). About 75% of people aged above 75 or older have cherry hemangioma. Hemangiomas are common, non cancerous tumors which can be removed by surgery and don’t come back. When a hemangioma disappears it leaves skin scarred and pigmented. It can grow anywhere in the body which are common and harmless. The size and appearance of the hemangioma varies as some are white, bluish soft mass under the skin. Infantile girls are more prone to this condition as compared to boys.

FACTS

• It is the extra growth of blood vessels formed on the skin, scalp and any part of the body.
• The main symptoms include are bright red color bumps and patches on the surface of the skin
• It may include treatment such as beta blockers and laser dye to remove hemangiomas.
• Capillary hemangioma is a vascular anomaly, which leads to overgrowth of small blood vessels in normal tissues.
• Nearly 10% hemangioma is seen in children’s orbit and eyelids, an account of nearly one in ten cases.

TYPES OF HEMANGIOMAS

There are two types of hemangiomas

1. Capillary Hemangioma

Infantile hemangiomas (strawberry hemangioma)

These are common growth of the blood vessels and more commonly seen in childrens, 12% of the babies by their first year. They look like a red bulge on the skin which grows normally between 1 quarter to some inches in size. Sometimes they are related to some disorders such as in the nervous system or in the spine. It may also be seen in the liver and brain.

Cherry hemangiomas

They are small, dot-like red blood vessels found on the torso. They are very common in adults and they are found in groups of a few dozen.

2. Cavernous Hemangioma

They form in the deeper layers of the skin, often seen around the eyes. They look like clusters of wide blood vessels which appear red to dark blue under the skin. It can lead to various problems regarding eye development such as amblyopia, cataracts.

Histopathology of Infantile Hemangioma

It has triphasic evolution

• Early proliferative or growth phase- There is rapid growth during the three months, deep infantile hemangioma tends to proliferate for a longer period of time.
• Plateau Phase- This lesion remains stable and for some period of months.
• Involution Phase- This phase is seen within the first year of life, continuing for several years. This hemangioma is softer, more compressible and the colour is red to purple. There are many residual changes such as fibrofatty tissue, skin laxity.

CAUSES

Hemangiomas are caused by the blood vessels which do not form properly. They grouped together into a dense clump.

SYMPTOMS

Hemangiomas of the skin usually appear as small red bumps, as they grow they look like burgundy color birthmarks. Sometimes the internal organs are present inside the body. It mainly affects gastrointestinal tract and liver such as

• Nausea
• Vomiting
• Loss of appetite
• Fullness of the abdomen

In a child’s first year, red marks grow rapidly into spongy, rubber-like bumps which stick out of the skin. When hemangioma enters a rest phase it begins to disappear slowly.

DEVELOPMENT OF HEMANGIOMAS

1. On the skin

There is abnormal proliferation of blood vessels in one area of the body. It forms in the top layer of the skin or sometimes in the fatty layer which is a subcutaneous layer. They are not usually present at birth.

2. On the liver

They are hepatic hemangiomas, on the surface of the liver. The non infantile hemangiomas of the liver are sensitive to estrogen. The excess estrogen can spur the growth of the liver and during pregnancy it can increase the size of hemangiomas.

Besides the skin and liver hemangiomas can grow within body such as

• Kidneys
• Colon
• Brain
• Lungs

DIAGNOSIS

• Ultrasound
• MRI
• CT Scan

DIFFERENTIAL DIAGNOSIS

• Congenital hemangioma
• Pyogenic granuloma
• Venous malformations
• Malignant tumors such as sarcoma, neuroblastoma
• Tufted hemangioma
• Port wine stain

TREATMENT

1. Beta Blockers Drugs

In small superficial hemangiomas a gel (Timolol) can be applied to the affected area, severe infantile hemangioma is treated with oral solution of propranolol.

2. Corticosteroid Medications

It is injected into the nodule and directly applied to the skin

3. Laser Surgery

It removes the thin hemangioma and treats the sore on hemangioma.

COMPLICATION

• Ulceration it include anogenital area, axilla and neck
• Ophthalmologic complication such as tear duct obstruction, amblyopia
• Airway obstruction in nasal, subglottic passages
• Difficulties in feeding
• Cosmetic disfigurement include large facial area
• PHACES syndrome
• LUMBAR syndrome with lumbosacral hemangiomas, myelopathy, anorectal arterial and renal anomalies.

AYURVEDIC MANAGEMENT

In ayurveda Capillary hemangioma is correlated with Raktavahyanarbud. These arbud (tumors) are sehaj (congenital) and sudamarbud (benign tumors). The benign tumors are devoid of suppuration and formed by meda (tissues which involve fat), kapha (blood vessels which are primarily involved). They are steady in nature and have a cyst like appearance. As it has cutaneous appearance, the birthmark is related to nayagach, which is described as minor skin disorders which is congenital and has brown, black birthmarks which are black in color and are often painless. If the dhatus and body tissues are not in equal proportion it is meant to be diseases, and dhatus aggravate leads to imbalance. The imbalance of agni is the main reason for the disproportion of seven dhatus. In arbud attack the uncontrollable development of cells varies the growth and rate.

HERBS USEFUL FOR CAPILLARY HEMANGIOMA

HARIDRA

Haridra (Curcuma longa) is useful and famous ayurvedic herb which has tikta katu rasa, katu vipaka and ruksha guna which helps to remove the blocked pathway of blood vessels makes the circulation of blood and passage of nutrient easy, maintains the normal blood functioning. It has immune modulating action and has antioxidant properties. Haridra restores the haematopoietic functions and removes the blockage in the liver.

VARUNA

Varuna (Crataeva nurvala) is a famous diuretic herb which is useful in migraine, intestinal worms and in renal calculi. It has ushna veerya, balances kapha and vata dosha and is light (laghu) to digest. It is a useful herb in abdominal tumors and in blood disorders. Useful herb in vata disorders such as paralysis, neuralgia. Its bark is useful in the treatment of liver and spleen disorders and in various skin disorders.

TEJAPATRA

Tejapatra (Cinnamomum tamala) is an herb used in the treatment of bad odor from mouth, dental caries and in tuberculosis. It has katu (pungent), tikta (bitter) taste. Has ushna veerya and helps to reduce the vitiated kapha and vata dosha, and increases pitta dosha. It is helpful in rhinitis, anorexia and in itching. Helps to reduce palpitation, improve lung capacity and is used as an appetizer which improves digestion.

KANCHNAAR

Kanchnaar (Bauhinia variegata) is an ayurvedic herb used in the treatment of thyroid, cervical lymphadenitis. It has Laghu (light to digest), rooksha (dry) qualities. It has sheetal veerya and relieves kapha and pitta dosha. It is a useful herb in the treatment of bleeding disorders, menorrhagia, in various skin diseases. It helps to relieve worm infestation, in rectal prolapse condition.

HERBAL REMEDIES FOR CAPILLARY HEMANGIOMA BY PLANET AYURVEDA

Planet Ayurveda is a GMP certified clinic which formulates their own herbal remedies and is used in every health condition. These formulations are prepared under the strict guidance of M.D experts. These remedies are free from any preservatives, resins and any other artificial synthetic material. These remedies are 100% pure and are used without causing any side effects. For this purpose planet ayurveda provided many herbal remedies which provided great relief.

PRODUCTS LIST

1. Kanchnaar Guggul
2. Graviola Capsules
3. Boswellia Curcumin
4. Nirgundi Oil

PRODUCTS DESCRIPTION

1. Kanchnaar Guggul

Kanchnaar Guggul are herbal tablets formulated by planet ayurveda using ingredients such as Kanchar Bark (Bauhinia variegata), Haritaki (Terminalia billerica), Cardamom (Elettaria cardamomum), Guggul (Commiphora mukul). These tablets help in reducing cancerous growth and provide nourishment to the affected area. Useful in Goitre, cysts, tumors and in various skin diseases.

Dosage- 1-2 tablets twice daily with lukewarm water.

2. Graviola Capsules

Graviola Capsules are single herbal capsules which are formulated by planet ayurveda using ingredients such as Graviola (Annona muricata). These capsules have various properties such as Anti bacterial, anti mutagenic, and have acetogenin constituent which is helpful against every cancer cell. Helps to boost the immune system and has an effect on tumors.

Dosage- 1-2 capsules twice daily.

3. Boswellia Curcumin

Boswellia Curcumin is polyherbal capsules which are formulated by planet ayurveda using ingredients such as Shallaki (Boswellia serrata), Curcumin (Curcuma longa). It is very helpful in treating joint disorders and in inflammatory diseases. It helps to pacify the doshas and helps in removing the toxins from the body, providing good blood functioning.

Dosage- 1 capsule twice daily with plain water after meals.

4. Nirgundi Oil

Nirgundi Oil is herbal oil formulation prepared by planet ayurveda using ingredients such as Tila Oil (Sesamum indicum), Manjistha (Rubia cordifolia), Kalahari (Gloriosa superba) and many more. This helps to treat many pain disorders and it has katu (pungent) Vipaka, with hot potency. Nirgundi oil acts as a analgesic, in female ailments and premenstrual syndrome. It is useful in many inflammatory conditions.

Method of applications- Apply over the affected people twice daily.

Contact Planet Ayurveda Support Team to provide you the costing / ordering and delivery information at – costing.planetayurveda@gmail.com or Call at 0172-521-4040 (India), +91-172-521-4040 (Outside India) or Whatsapp at (+91) 9915-593-604

CONCLUSION

Hemangiomas or infantile hemangiomas are the non cancerous growth of the blood vessels which are found on the skin. The blood vessels are the components of the circulatory system which transports the blood throughout the body. It is also known as the Strawberry mark which is present at the birth time or usually in the first weeks of life. It can occur anywhere in the body such as on the face, scalp, chest and back. Hemangioma looks like a rubbery lump which is made up of extra blood vessels in the part of the skin. Planet Ayurveda provides many herbal remedies which will provide great relief without causing any side effects and maintain a healthy living.