BACKGROUND: More and more infantile hemangiomas (IH) are being treated with 
propranolol, but the effectiveness, dosage, and treatment course are still in 
dispute. The aim of this observational study was to describe the therapeutic 
response, tolerance, and safety of low-dose propranolol in 23 children with IH 
of the head and neck.
METHODS: Data were collected from the medical charts of patients treated with 
low-dose propranolol from December 2009 through November 2011. Oral dose was 
1-1.5 mg/kg once per day. Blood pressure and heart rate were monitored during 
the first 24 h of treatment. In the absence of side-effects, treatment was 
continued at home and the child was re-evaluated every month.
RESULTS: All patients had a good response, even if treated with corticosteroid 
previously. Color and growth changes within 1 week were noted. Treatment 
continued for a mean total duration of 6 months until the IH had totally 
disappeared or stabilized. There were no severe adverse reactions. Side-effects 
were limited and mild, including blood pressure decrease, somnolence, and 
nausea. No relapse was noted.
CONCLUSIONS: Low-dose propranolol appears to be effective and safe for IH, 
especially for those patients previously treated with corticosteroid and who had 
no response or severe side-effects.