Treatment with propranolol for infantile hemangiomas: single-center experience

Infantile hemangiomas (IHs) are the most common soft tissue tumors of infancy. Although spontaneous regression is expected, medical treatment is needed in approximately 10-20% of cases.

We aimed to assess the safety and efficacy of systemic propranolol for the treatment of IH.

Medical records of 34 eligible patients were analyzed retrospectively.

Treatment indications were local complications (hemorrhage, ulceration) in 38.2% of patients, cosmetic risk and face deformity in 35.3%, life-threatening organ dysfunction in 17.6%, and impending visual impairment in 8.8%. The median age at start of treatment with propranolol was 3.5 months (range, 2-65 months). The median duration of propranolol treatment was 8 months (3-12). Response was graded as excellent (>75% improvement) in 30 patients (88.2%) and good (50-75% improvement) in 3 (8.9%). Recurrence was not observed after termination of treatment. None of our patients showed severe side effects at the beginning of or during the treatment.

Propranolol is a well-tolerated, efficacious, and safe drug for treatment of IH. It can be initiated and administered in the outpatient setting. Our report supports the excellent effect and good tolerance of this novel therapy, and we propose the use of propranolol as first-line treatment for IH.