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Topical 1% propranolol effectively treated infantile hemangiomas

Patients with superficial infantile hemangiomas were safely and effectively treated with a novel topical 1% propranolol ointment in a recent study.

Researchers in China conducted a retrospective chart review of 25 children (aged 1 to 10 months; 21 girls) with 28 infantile hemangiomas (IH) who were treated with 1% propranolol ointment. The IH, ranging from 0.56 cm2 to 376 cm2, were located on the trunk (35%), in the head and neck region (29%), on the extremities (29%) and in the perineum region (7%). Patients received a clinical evaluation, including palpation to determine surface tension at the lesions, photographs to record the location, size and color of the lesions, and ultrasounds to measure maximal lesion thickness. Electrocardiographic, blood pressure, heart rate and blood glucose evaluations also were performed.

Topical propranolol (oral propranolol crushed pills/petroleum jelly: 10 mg/1g) was applied three times daily to a clean, dry IH area for a mean of 21 weeks. At regular intervals, changes in size, texture and tumor color were monitored and recorded through photographs. A 3-point scale (good, partial, no response) was used to evaluate treatment response. Sixteen (57%) of the IH showed good response, nine (33%) displayed partial response and three (10%) had no response, resulting in 90% of all IH demonstrating good or partial treatment response (95%CI, 72%-98%).

No adverse events, such as rash, gastrointestinal discomfort/reflux, hypoglycemia, bronchospasm and hypotension, were observed.

“Topical therapy with 1% propranolol ointment may be a safe and effective method for treating superficial IH and can be used as an adjuvant treatment during the wait-and-see period,” the researchers concluded. “Given the small sample size, further investigation is needed to determine the safety and efficacy of topical propranolol.”