Diagnosis and management of infantile hemangiomas

Pediatr Clin North Am. 2014 Apr;61(2):383-402. doi: 10.1016/j.pcl.2013.11.010. Epub 2014 Feb 18.


Propranolol has replaced corticosteroids as preferred first-line therapy for the management of infantile hemangiomas (IH). The topical β-blocker timolol is now an alternative to oral propranolol and watchful waiting for smaller IH. Research in the last decade has provided evidence-based data about natural history, epidemiology, and syndromes associated with IH. The most pressing issue for the clinician treating children with IH is to understand current data to develop an individualized risk stratification for each patient and determine the likelihood of complications and need for treatment. This article emphasizes the nuances of complicated clinical presentations and current treatment recommendations.

Keywords: Infantile hemangioma; PHACE syndrome; Propranolol; Timolol; β-Blocker.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / administration & dosage
  • Adrenergic beta-Antagonists / therapeutic use
  • Diagnosis, Differential
  • Hemangioma / diagnosis*
  • Hemangioma / drug therapy*
  • Humans
  • Infant
  • Propranolol / administration & dosage
  • Propranolol / therapeutic use
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / drug therapy*


  • Adrenergic beta-Antagonists
  • Propranolol