In most cases, hemangiomas do not need to be treated if they’re small or in areas that would not affect the patient’s appearance or function. If the hemangioma is in an area that would affect either their appearance or their function, you should treat it. The treatment can be as simple as using a topical gel called Timolol. For flatter appearing ones, using an oral medication called propranolol, which is currently the most effective for shrinking hemangiomas around the body in general. Or you can use a Pulsed Dye Laser or other types of lasers that hit red – Pulsed Dye being the gold standard to help shrink the hemangioma or birth mark. If the hemangioma is larger or obstructive, surgery is often needed. The surgery, again, can be performed with laser or it can be performed with direct excision since these are all encapsulated tumors. Beyond that, some people have tried Sclera Therapy – usually not for hemangiomas but for other birthmarks. Those combination of things usually take care of hemangiomas. When you get to venous malformations and lymphatic, they become a little more complicated. But most of what our patients would see in the population is just a straightforward infantile hemangioma.