Propranolol hydrochloride is a nonselective β-blocker that is used for the 
treatment of hypertension, arrhythmia, and angina pectoris. In Japan, it was 
recently approved for the treatment of childhood arrhythmia. It has been 
observed to produce drastic involution of infantile hemangiomas. The aim of this 
prospective study was to examine propranolol's superiority to classical therapy 
with pulsed dye laser and/or cryosurgery in treating proliferating infantile 
hemangiomas. Fifteen patients between the ages of 1 and 4 months with 
proliferating infantile hemangiomas received grinded propranolol tablets 2 mg/kg 
per day divided in three doses. Twelve patients with proliferating infantile 
hemangiomas receiving pulsed dye laser and/or cryosurgery were enrolled as 
controls. Baseline electrocardiogram, echocardiogram, and chest x-ray were 
performed. Monitoring of heart rate, blood pressure, and blood glucose was 
performed every 2 weeks. Efficacy was assessed by performing blinded volume 
measurements and taking photographs at every visit. Propranolol induced 
significantly earlier involution and redness reduction of infantile hemangiomas, 
compared to pulsed dye laser and cryosurgery. Adverse effects such as 
hypoglycemia, hypotension, or bradycardia did not occur.
CONCLUSION: The dramatic response of infantile hemangiomas to propranolol and 
few side effects suggest that early treatment of infantile hemangiomas could 
result in decreased disfigurement. Propranolol should be considered as a 
first-line treatment of infantile hemangiomas.