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Hemangeol (propranolol hydrochloride) is the first FDA-approved medication for the treatment of infantile hemangiomas. Propranolol is a beta-blocker that has been used for over 40 years for the treatment of cardiovascular conditions; it has been increasingly used off label since 2007 for treatment of infantile hemangiomas (see also NEJM JW Dermatol Feb 22 2013 and Jun 20 2008). Drug manufacturer Pierre Fabre has conducted safety and efficacy studies of its proprietary drug Hemangeol confirming the clinical experience of pediatric dermatologists that propranolol should be the first-line treatment for hemangiomas that need intervention. Dosing is 3 mg/kg/day, divided twice daily. Unfortunately, the studies compared 1 mg/kg/day versus 3 mg/kg/…