My 9 month old daughter had a hemangioma on her upper back. We have been dealing with ulcerations for MONTHS. We were to the point that the hemangioma was measuring 6 cm by 6 cm and the ulceration was 5.5 cm by 5.5 cm. The whole thing was ulcerated. We finally just had hers excised on Wednesday. The best decision that we ever made!! We had tried every dressing, ointment, pulse dye laser, everything... The pain was affecting our daughter developmentally as well.
Some of the things that we found that helped in the meantime... We were always advised to keep the ulceration covered and moist. We kept something on it at all times, even during bathtime (usually a clear tegaderm over whatever other dressing/ointment we were using at the time).
Our routine was to do dressing changes after her bath. One thing that I found that helped was lidocaine (as previously mentioned). I would put a thin layer of lidocaine on the ulceration and then bathe my daughter. I let her sit and play in the tub for 15 minutes or so while the lidocaine worked. This does numb the area really well.
Some of the ointments that we tried were: silvadene, Regranex, Biafene, Bacitracin. Although they didn't work for us, I have read of other people having great success with them.
Pulse dye laser is another option that some have success with. It is very expensive if you insurance doesn't cover it.
One thing that you really want to watch for is infection. We always knew if the ulceration was infected when it started smelling bad. My daughter had staph 3 times, e. coli, and pseudomas.
Don't give up... I would be more than happy to share our experiences. I have done a ton of research on ulcerations and my daughter went to a great wound care clinic for 3 months. Be persistent... The longer that it is ulcerated, the more chance it has of becoming infected and the ulceration growing larger. Children are resilient.