Atenolol versus propranolol for the treatment of infantile hemangiomas: a randomized controlled study

J Am Acad Dermatol. 2014 Jun;70(6):1045-9. doi: 10.1016/j.jaad.2014.01.905. Epub 2014 Mar 20.


Background: Infantile hemangiomas have a dramatic response to propranolol, a nonselective beta-blocker. However, this treatment is not risk-free and many patients are excluded because of respiratory comorbidities. Atenolol is a cardioselective beta-blocker that may have fewer adverse events.

Objective: We sought to evaluate the effectiveness of atenolol against propranolol in a noninferiority trial.

Methods: In all, 23 patients met the inclusion criteria and were randomized to receive either atenolol or propranolol. Thirteen patients were treated with atenolol and 10 with propranolol. Follow-up was made at baseline, 2 weeks, 4 weeks, and then monthly for 6 months.

Results: Patients treated with atenolol had a complete response of 53.8% and 60% with propranolol, respectively. These results were nonsignificant (P = .68). Relevant adverse events were not reported.

Limitations: The reduced number of patients could have influenced our results.

Conclusion: Atenolol appears to be as effective as propranolol. We did not find significant differences between these results or any adverse events.

Keywords: atenolol; beta-blockers; hemangiomas; propranolol; randomized; treatment; trial.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Atenolol / therapeutic use*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Hemangioma, Capillary / congenital
  • Hemangioma, Capillary / drug therapy*
  • Hemangioma, Capillary / pathology
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Propranolol / administration & dosage*
  • Risk Assessment
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / pathology
  • Time Factors
  • Treatment Outcome


  • Adrenergic beta-Antagonists
  • Atenolol
  • Propranolol