Oral versus topical propranolol for management of superficial infantile hemangiomas: a comparative study

Abstract

Background/purpose: Oral propranolol has been used successfully for the treatment of infantile hemangiomas (IHs). However, its safety is questioned. Topical therapy with 1% propranolol ointment has been reported to be safe
and effective. The objective of this study was to compare the effectiveness and safety of oral versus topical propranolol (1% ointment) as a nonselective b-blocker in the management of cutaneous IH.

Patients and methods: Forty-eight patients with IH were randomly divided into two equal groups: group A (n= 24) was treated with oral propranolol and group B (n= 24) was treated with propranolol ointment 1%. The patients were followed up for 3 months after treatment was stopped.

Results: There was a significant statistical difference between the two groups as regards the effectiveness of the drug (P = 0.041). In the oral group, 50% (n= 12) showed an excellent response, 33.33% (n= 8) showed good response, and 16.67% (n =4) showed a fair response, whereas in the topical group 16.67% (n= 4) showed an excellent response, 45.83% (n= 11) showed good response, and 37.5% (n= 9) showed a fair response. There was no significant adverse event in any group during the follow-up period.

Conclusion: Oral propranolol is an effective, safe, and fastacting drug for treating IH and can be monitored on an outpatient basis. Topical propranolol is an easily prepared drug and seems to be an alternative therapeutic option for superficial cutaneous hemangioma. However, the optimal dosing and duration of treatment are still to be defined. 

Keywords: infantile hemangiomas, propranolol, propranolol ointment, topical propranolol