• Ari Raheem Zangana Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
  • Ala Ismail Shakur Ashty Hospital, Soran, Kurdistan Region, Iraq.



Hemangioma, Infantile hemangioma, Proliferative phase, Propranolol



Infantile Hemangiomas (IH) are the most common benign tumour during childhood. Although most of the lesions do not require any treatment, problematic IH needs some sorts of intervention. Oral propranolol by a complex mechanism of action is considered as an effective way for the treatment of IH. 


The present study was conducted to clinically evaluate the outcome of propranolol as a treatment tool for proliferating infantile hemangiomas.

Patients and Methods

In this study, 17 infants, 10 males and 7 females were included in the multicenter prospective study. All infants were in the proliferative phase. Propranolol was given at a dose of 0.5 mg/kg body weight per day in two divided doses with food for one week; then the dose increased to 1-3 mg/kg body weight according to clinical response by evaluating color, firmness, surface consistency of the lesion, depth and size ranging for a period of 4-12 months duration


Most hemangiomas have elicited gradual fading of color, followed by steadily softening and decreasing in thickness of hemangiomas. Through a total no. of 17 cases before propranolol therapy, 15 cases had bright red color and 2 cases had pale color lesions. After taking propranolol therapy, only two lesions have still retained their red color, while 14 cases had clear fading of the color to pale color, and one of the cases has gained complete disappearance of the color of hemangioma to a normal skin color


Within the limitations of this prospective study, oral propranolol at a dose of 1-3 mg/kg in divided doses started during the proliferative phase, had effective therapeutic responses. However, this still needs more studies to prove the safety and efficacy of the drug.


Nguyen .Beta-Blockers as Therapy for Infantile Hemangiomas / Seminars in Plastic Surgery Vol. 28 No. 2/2014 DOI:

Tan ST, Velickovic M, Ruger BM, Cellular and extracellular markers of hemangioma. PlastReconstrSurg 2000;106:529e37. DOI:

Mulliken JB, Glowacki J.Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. PlastReconstrSurg 1982;69:412e9. DOI:

Z.G. Chen . A novel topical nano-propranolol for treatment of infantile hemangiomas / Nanomedicine: Nanotechnology, Biology, and Medicine 11 (2015) 1109–1115 . DOI:

Metry DW, Hebert AA. Benign cutaneous vascular tumors of infancy: when to worry, what to do. Arch Dermatol 2000;136(7):905–914. DOI:

Bigorre, Michele; Van Kien, Aurelie Khau; Valette, Huguette. Beta-Blocking Agent for Treatment of Infantile Hemangioma. PRS Journal : June 2009 - Volume 123 - Issue 6 - p 195e-196e DOI:

Haggstrom AN, Drolet BA, Baselga E, Prospective study of infantile hemangiomas: clinical characteristics predicting complications and treatment. Pediatrics. 2006;118(3): 882–887 ). DOI:

Fawcett SL, Grant I, Hall PN, Kelsall AW, Nicholson JC. Vincristine as a treatment for a large haemangioma threatening vital functions. Br J PlastSurg 2004;57: 168–171. DOI:

Perez J, Pardo J, GomezC. Vincristine—an effective treatment of corticoid-resistant life-threatening infantile hemangiomas. ActaOncol 2002;41:197–199. DOI:

Buckmiller et al.: Propranolol for Infantile Hemangiomas: Early Experience at a Tertiary Vascular Anomalies Center, Laryngoscope 120: April 2010. DOI:

Leaute-Labreze C, Dumas de la Roque E, Hubiche T, Boralevi F, Thambo JB, Taieb A. Propranolol for severe hemangiomas of infancy. N Engl J Med 2008;358: 2649–2651. DOI:

Markus Shneider, Andres Reimer, Hnasjoerg Cremer, Peter Ruef. Topical treatment with propranolol gel as a supplement to the existing treatment of hemangiomas. World J Pediatr, Vol 10 No 4. November 15, 2014. DOI:

Marqueling AL, Oza V, Frieden IJ, Puttgen KB. Propranolol and infantile hemangiomas four years later: a systematic review. PediatrDermatol. 2013;30(2):182–91. DOI:

JingGe, JiaweiZheng, LingZhang, WeienYuan, HaiguangZhao. Oral propranolol combined with topical timolol for compound infantile hemangiomas: a retrospective study. Scientific Reports | 6:19765 | DOI: 10.1038/srep19765 DOI:

Hogeling M, Adams S, Wargon O. A randomized controlled trial of propranolol for infantile hemangiomas. Pediatrics 2011;128:e259-66 DOI:

E. baselga. Past, Present, and Future of Propranolol for Hemangiomas of Infancy. ActasDermosifiliogr. 2011;102(7):484---486 . DOI:

Xiaohan Liu , Xinhua Qu, Jiawei Zheng, Ling Zhang. Effectiveness and Safety of Oral Propranolol versus Other Treatments for Infantile Hemangiomas: A Meta-Analysis. journal. pone.0138100 September 16, 2015 DOI:

Sérgio Laranjo, Glória Costa, Filipa Paramés, Isabel Freitas, José Diogo Martins, Conceição Trigo,et al. The role of propranolol in the treatment of infantile hemangioma. j. repce.2013.10.047



How to Cite

Zangana A, Shakur A. ROLE OF ORAL PROPRANOLOL IN THE TREATMENT OF INFANTILE HEMANGIOMAS. JSMC [Internet]. 2020 Mar. 21 [cited 2024 Jul. 21];10(1):1-10. Available from:

Similar Articles

1-10 of 14

You may also start an advanced similarity search for this article.