Published: 2019-09-25

Role of propranolol in the management of infantile hemangioma

Manwendra Kumar, Sudhir Kumar, Pankaj K. Chaudhary, Amit Kumar


Background: Infantile hemangiomas are the most common benign soft tissue tumor of infancy and childhood occurring 4-10% of all infants. It is more frequent in premature children (23% of infants <1200g) and females (3:1 to 5:1). For many hemangiomas treatment is not required, however hemangioma in some locations need treatment to prevent complication. The Present study was done with an Aim to assess the efficacy and safety of oral Propranolol in management of infantile heamangioma in our set-up.

Methods: This study was conducted from May 2016 to Nov 2017 at Department of Surgery and Pediatrics, M.L.B. Medical College, Jhansi after obtaining Ethical permission. Patients having confirmed were recruited & admitted for initiation of Oral Propranolol therapy for 5 days under the observation of Paediatrician. Oral Propranolol treatment was continued till the age of 11/2 years. A clinical assessment was made at each visit to the Outpatients Clinic every four weeks.

Results: The incidences of infantile hemangioma were more in age group (0-7 months) i.e 55% (22 patients) followed by age group of (8-15 days) i.e. 30% (12 patients). As age advances presentation gradually decreases as after 30 days incidence is only 5%. Infantile hemangioma were more common in females’ patients (55% patients) & mostly 90% (36 patients) present as single lesion and only 10% (4 patients) present as multiple lesions. Most of hemangiomas presented as reddish in color 80% (32 patients) which reflected lesions are mostly superficial & only 10% were brownish red and 10% skin color indicated incidence of deeper penetration.

Conclusion: Authors found that drug (Propranolol) to be effective even at low dose of 1mg/kg/day. In our study group it was effective and safe in almost all patients.


Age, Infantile hemangioma, Lesion, Patients, Propranolol, Treatment

Full Text:



Hoornweg MJ, Smeulders MJ, Ubbink DT, van der Horst CM. The prevalence and risk factors of infantile haemangiomas: a case-control study in the Dutch population. Paediatr Perinat Epidemiol. 2012;26(2):156-162.

Keller RG, Patel KG. Evidence-based medicine in the treatment of infantile hemangiomas. Facial Plast Surg Clin North Am. 2015;23(3):373-392.

Shayan YR, Prendiville J, Goldman RD. Use of propranolol in treating hemangiomas. Can Fam Physician. 2011;57(3):302-303.

Leaute-Labreze C, Boccara O, Degrugillier-Chopinet C, Mazereeuw-Hautier J, Prey S, Lebbe G, et al. Safety of oral propranolol for the treatment of infantile hemangioma: a systematic review. Pediatr. 2016 Oct;138(4):e20160353.

Izadpanah A, Izadpanah A, Kanevsky J, Belzile E, Schwarz K. Propranolol versus Corticosteroids in the Treatment of Infantile Hemangioma: A Systematic Review and Meta-Analysis. Plast Reconst Surg. 2013:131(3).

Burns AJ, Navarro JA, Cooner RD. Classification of vascular anomalies and the comprehensive treatment of haemangiomas. Plast Reconstr Surg. 2009;124(1):69e-81e.

Mulliken JB, Young AE. Vascular Birthmarks: Hemangiomas and Malformations. Philadelphia: Saunders. 1988:24-103.

Rolet BA, Swanson EA, Frieden IJ, Infantile hemangiomas: an emerging health issue linked to an increased rate of low birth weight infants. J Pediatr. 2008;153(5):712-15.

Gampper TJ, Morgan RF. Vascular Anomalies: Hemangiomas. Plast Reconst Surg . 2002:110(2):572-86.

Laranjo S, Costa G, Paramés F, Freitas I, Martins JD, Trigo C, et al. The role of propranolol in the treatment of infantile hemangioma. Sociedade Portuguesa de Cardiologia. Published by Elsevier España. 2013:290-5.

Sans V, de la Roque ED, Berge J, Grenier N, Boralevi F, Mazereeuw-Hautier J, et al. Propranolol for severe infantile hemangiomas: follow up report. Pediatr. 2009;124(3):423-31.

Celik A, Tiryaki S, Musayev A Kismali E, Levent E, Ergun O. Propranolol as the first line therapy for infantile hemangiomas: preliminary results of two centers. J Drugs Dermatol. 2012;11(7):808-11.

NeriI, Balestri R, Patrizi A. Hemangiomas: new insight and medical treatment. Dermatol Ther. 2012;25(4):322-34.

Phillips CB, Pacha O, Biliciler-Denkta G, Hebert AA. A review of beta antagonist treatment for infantile hemangioma. J Drugs Derma-tol. 2012; 11(7):826-9.

Price CJ, Lattouf C, Baum B, McLeod M, Schachner LA, Duarte AM, et al. Propranolol vs corticosteroids for infantile hemangiomas: a multi center retrospective analysis. Arch Dermatol. 2011; 147(12):1371-6.

Leaute-Labze C, Taieb A. Efficacy of beta blockers in infantile capillary haemangiomas: the physiopathological significance and therapeutic consequences. Ann Dermatol Venereol. 2008; 135(12): 860-2.

Léauté-Labrèze C, De La Roque ED, Hubiche T, Boralevi F, Thambo JB, Taïeb A. Propranolol for severe hemangiomas of infancy. N Eng lJ Med. 2008; 358(24): 2649-51.