Pain management for ulcerated infantile hemangiomas.

Perioral ulcerated hemangiomas in infants can present a therapeutic challenge to clinicians, especially when associated with severe pain and difficulty feeding. Topical and oral pain medications can be beneficial, but feeding difficulties may still occur while awaiting healing of the ulceration with the use of systemic or topical agents. We present a case of an infant with an ulcerated lip hemangioma treated with an over-the-counter topical sealant in combination with systemic corticosteroid therapy who showed dramatic improvement in pain and tolerance to feeding, resulting in healing of the ulceration.