PURPOSE: Genital infantile hemangiomas are vascular anomalies that often require 
complex management and interdisciplinary care. Propranolol was first used to 
treat patients with infantile hemangiomas in 2008 and has since gained 
acceptance as first-line therapy.
MATERIALS AND METHODS: We review the presentation, course, management and 
outcomes of all cases of genital infantile hemangiomas managed by propranolol 
administration at a single institution from April 2010 to July 2014.
RESULTS: During the study period 9 patients with genital infantile hemangiomas 
were referred to our hemangioma treatment clinic. Propranolol was initially 
administered under careful outpatient monitoring at a dose of 1 mg/kg daily in 8 
patients. One patient, a 700 gm premature infant, was started on therapy in the 
inpatient setting at 0.5 mg/kg daily, given the history of prematurity. All 
patients underwent successful increase of dose to at least 2 mg/kg for the 
observation phase after tolerating the starting doses. One patient discontinued 
propranolol prematurely per parental request due to concern regarding peripheral 
vasoconstriction. Otherwise, no patient demonstrated significant hypotension, 
symptomatic bradycardia, hypoglycemia or other major side effect requiring 
treatment discontinuation. All patients who continued the treatment protocol had 
excellent response to therapy.
CONCLUSIONS: Propranolol therapy for genital infantile hemangiomas was 
successfully initiated and the dosage increased in 9 young children without 
significant side effects and with marked improvement in all patients who 
continued on treatment. Propranolol is the only Food and Drug Administration 
approved therapy for treatment of patients with this vascular anomaly and should 
be considered first-line therapy for genital infantile hemangiomas.