Propranolol for Infantile Hemangioma: Safety Issues and Proposed Protocol

Infantile hemangiomas (IHs) are common, self-limited vascular tumors that usually require no intervention. However, some hemangiomas require treatment to preserve function (visual, airway) or treat ulceration. The usual treatment is systemic glucocorticoids (typically prednisolone at 2 mg–5 mg/kg/day). Interferon alfa, vincristine, and cyclosporine are other therapeutic options, but these agents have increased risks compared to steroids. In 2008, a series of 11 IHs were successfully treated with oral propranolol, with responses that appeared to be faster and better than with corticosteroids (JW Dermatol Jun 20 2008). Although issues of administration and safety were not discussed, propranolol use by pediatric dermatologists has increased. N…