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Until recently, the mainstay of therapy for problematic infantile hemangiomas (IHs) was systemic corticosteroids. In the last few years, off-label use of oral propranolol has become widespread. Timolol gel, a topical beta-blocker commonly used to treat glaucoma, has produced largely positive results in small groups of patients with superficial hemangiomas (JW Dermatol Mar 26 2010 and JW Dermatol Jun 18 2010).
These authors performed a retrospective, multicenter study of 73 patients (mean age at onset, 3 weeks) who had received topical timolol maleate 0.1% or 0.5% gel without other concomitant IH treatment. The head and neck area was the most common location (85%), most hemangiomas were superficial, and none were ulcerated. Mean age at hemang…