Topical Propranolol or Timolol for Infantile Hemangiomas

Topical therapy with 1% propranolol ointment or 0.5% Timolol drops/gel may be a safe and effective method for treating superficial Infantile Hemangiomas and can be used as an adjuvant treatment during the wait-and-see period. 

An Earlier initiation of treatment (less than 3 months of age) has been associated with relatively better outcomes.

Topical propranolol is prepared by crushing and mixing oral pills in petroleum jelly or water to get a concentration of 10 mg per gm or ml(i.e.1%) 

Application is done three times daily  for a period of three weeks and at regular intervals, changes in size, texture and color should be monitored and recorded through photographs. 

Adverse events such as rash, gastrointestinal discomfort/reflux, hypoglycemia, bronchospasm or  hypotension, which are seen in Oral propranolol use are rarely seen with topical therapy.

TIMOLOL which is more easily available over the counter for ocular use  as 0.5% hydrogel (2 times daily)  or  0.5% drops (6 drops 3 times daily) has been shown to have equally good results with Itching reported as most common adverse effects.

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