Medical Management of Infantile Hemangiomas: An Update

Paediatr Drugs. 2022 Jan;24(1):29-43. doi: 10.1007/s40272-021-00477-9. Epub 2021 Oct 22.

Abstract

Infantile hemangioma (IH) is the most common benign vascular tumor of infancy, affecting about 5% of infants. It has a characteristic growth pattern of early rapid proliferation followed by progressive involution. Although most IH evolve favorably, complications are observed in 10-15% of cases, justifying treatment. For over 10 years now, propranolol has become the first-line therapy for complicated IH, revolutionizing their management and their prognosis. In this article, we review the clinical features, associations, complications/sequelae and therapeutic approaches for IH, focusing on current medical therapy. Indications for treatment and various treatment options, including propranolol and other oral β-blockers, topical timolol, and corticosteroids are presented. Current controversies regarding oral propranolol such as pre-treatment screening, in- vs out-patient initiation of treatment, early and potential long-term side effects and recommended monitoring are discussed.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adrenergic beta-Antagonists / therapeutic use
  • Hemangioma* / drug therapy
  • Humans
  • Infant
  • Propranolol / therapeutic use
  • Skin Neoplasms*
  • Timolol
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Adrenergic beta-Antagonists
  • Timolol
  • Propranolol