Topical propranolol effective in small infantile haemangiomas

Infantile haemangiomas are the most common tumour of infancy which in a majority of cases involute spontaneously. The first‐line treatment of Infantile haemangiomas is oral propranolol which has a risk of systemic adverse effects.

Price A and colleagues conducted a Systematic review and meta-analysis to investigate the role of topical preparations in Infantile haemangiomas and found that topical propranolol was effective in small, superficial haemangiomas. The findings have been published in Journal of the European Academy of Dermatology and Venereology

The researchers followed PRISMA guidelines and searched four databases to identify original articles evaluating the use of topical propranolol as the primary therapy for infantile haemangiomas. Twelve articles with a total of 597 patients and 632 haemangiomas were included. Three topical propranolol preparations were used, creams, ointments, and gels and were all prepared by local pharmaceutical laboratories. The concentration of propranolol ranged from 0.5% to 5% and the treatment duration ranged from two weeks to 16.5 months.

The researchers found that in all, 90% of lesions improved following the initiation of topical propranolol. A good or excellent response, defined as a reduction in the size of at least 50%, was seen in 59% of lesions. Earlier initiation of treatment (less than 3 months of age) was associated with improved outcomes.

There were no systemic adverse effects with only minor local reactions in 1.3% of patients. Topical propranolol is safer than oral propranolol, though may be less effective. It may be more suitable for patients with small, superficial haemangiomas at risk of cosmetic sequelae, where the cosmetic or symptomatic impact does not warrant oral propranolol treatment.