Propranolol has been used successfully in a limited number of children with 
infantile hemangiomas. This multicenter retrospective study describes the 
efficacy and adverse effects of propranolol in infantile hemangioma. Seventy-one 
infants with infantile hemangiomas were treated with oral propranolol, 1 
mg/kg/12 hours, for at least 12 weeks. A photograph based severity scoring 
assessment was performed by five observers to evaluate efficacy, utilizing a 
scoring system of 10 as the original infantile hemangioma before treatment and 0 
as completely normal skin. The mean of the five independent measurements was 
used in the analysis. Propranolol was a rapid and effective treatment for 
infantile hemangiomas at 4 weeks (p < 0.001), at 8 weeks (p < 0.001 compared to 
the 4 wks value), at 12 weeks (p < 0.05 compared to the 8 wks value), and 
thereafter up to 32 weeks (p < 0.01 compared to the 16 wks value). The response 
of infantile hemangiomas to propranolol was similar regardless of sex, age at 
onset of treatment, type of involvement (segmental and nonsegmental), facial 
segments affected, special locations (eyelid, nasal tip, and parotid region), 
ulceration, and depth of infantile hemangiomas. Very few side effects were 
reported; mainly agitated sleep in 10 of 71 patients. In the series of patients 
in this study, oral propranolol 2 mg/kg/day was a well-tolerated and effective 
treatment for infantile hemangiomas. Prospective studies are needed to establish 
the exact role of propranolol in the treatment of infantile hemangiomas.