Effect of propranolol on the treatment of infantile hemangiomas: a single tertiary center 3-year experience

Background: Propranolol has recently become a successful first-line therapy in the treatment of infantile hemangiomas (IHs). Objective: To evaluate and analyze the authors' experience of propranolol treatment for IHs. Methods: A retrospective, observational study was conducted. Medical records were reviewed. To evaluate the outcome of treatment, serial digital photographs using a visual analog scale were compared. Results: Eighty-three patients with a mean age of 5.35 +/- 5.15 months had 107 IHs treated by oral propranolol at a dose of 2 mg/kg/day. The mean percent improvement in the size and extent were 14.3% at 1 week, 45.4% at 9 weeks, 69.1% at 21 weeks and 83.8% at 53 weeks after beginning propranolol treatment. Eight patients (9.6%) reported mild side effects including hypoglycemia (n = 4), hypotension without associated symptoms (n = 2), bradycardia (n = 1) and somnolence (n = 1). Regrowth of IH after cessation of propranolol was reported in 18 patients (21.7%). There is no significant predictor of response to treatment and regrowth after cessation of treatment. Conclusions: Propranolol was highly effective and safe in the treatment of IHs. Effect of propranolol treatment started rapidly within 1 week, and was very promising regardless of patients' and lesions' characteristics. Based on the authors' observation, they suggest that treatment should be continued several months after the proliferative phase is considered to stop clinically.