One might anticipate that as a child matured, any physical stigmata would have impact on growth and development. Costa and colleagues chose to assess the impact of facial hemangiomas both with and without prior treatment in preteen children. They performed an observational study of social anxiety and skills in preteens with facial hemangiomas using 3 accepted psychiatric scales. Thirty of 144 reachable parents of preteens in this category completed questionnaires. The authors found that preteen children with involuted, untreated hemangiomas had higher social anxiety scores in new situations and reduced social initiative scores compared with children who had received therapy. Despite the limited cohort in the study, the question of whether early treatment for facial hemangiomas in obvious facial areas warrants consideration.