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Published on: December 31, 2015
Efficacy of propranolol for cutaneous hemangiomas in premature children
Valeria Brazzelli1, Chiara Giorgini, Stefania Barruscotti
1Institute of Dermatology, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, San Matteo Polyclinic and Scientific Research Foundation, University of Pavia, Pavia, Italy - v.brazzelli@smatteo.pv.it.
Insights
Propranolol effectively treats problematic infantile hemangiomas (IH) in children, with premature infants showing a superior response. This study evaluated 24 infants, finding significant improvement and minimal side effects.
Area of Science:
- Pediatric Dermatology
- Neonatology
- Pharmacology
Background:
- Infantile hemangiomas (IH) are common vascular tumors in infants.
- Problematic IH can lead to complications, necessitating effective treatment.
- Propranolol has emerged as a first-line therapy for IH.
Purpose of the Study:
- To assess the efficacy and safety of oral propranolol for problematic infantile hemangiomas.
- To specifically evaluate treatment outcomes in premature infants compared to term infants.
Main Methods:
- Retrospective observational study of 24 patients treated with oral propranolol.
- Multidisciplinary team approach for treatment indication and follow-up.
- Standardized clinical gravity score used to quantify IH improvement before and after therapy.
Main Results:
- 96% of infantile hemangiomas showed improvement, with a median score reduction of 69.1%.
- Premature infants demonstrated significantly greater improvement (80.9%) compared to term infants (49.6%).
- No significant adverse effects were reported during propranolol treatment.
Conclusions:
- Oral propranolol is an effective and safe treatment for problematic infantile hemangiomas.
- Premature infants exhibit a notably enhanced response to propranolol therapy for IH.
Background:
The purpose of the present study is to evaluate the efficacy and safety of propranolol for problematic infantile hemangiomas (IH), showing our experience on 24 children, with special focus on premature infants.
Methods:
A retrospective observational study considered 24 patients who were given oral propranolol for the treatment of "problematic" IH. A multidisciplinary team, composed of a dermatologist, a pediatrician, a pediatric cardiologist, and a neonatologist, took part in the indication for propranolol and follow-up on all the patients. Propranolol was administered orally at the starting dose of 0.5-1 mg/kg/die and was gradually increased to the target dose of 2 mg/kg/die. A clinical gravity score, based on color, major diameter, thickness and texture was calculated for each IH, giving a numeric score before (t0) and after (tf) propranolol therapy. Improvement rate was evaluated in terms of score percentage difference between t0 and tf.
Results:
All of the IH except one (96%), showed a variable grade of improvement, with a median score improvement of 69.1%. Median initial score in premature and term infants did not show any significant difference (P=0.38). Otherwise the two subgroups showed a significant difference in final scores: medium percentage improvement in premature and term infants, was respectively 80.9% and 49.6% (P<0.01). No significant side effects were reported during the treatment period.
Conclusions:
As pointed out in our study, IH in premature children showed a significantly better response to propranolol treatment.
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