Propranolol, used for many years in cardiac patients, is a recent “discovery” that has been shown to be successful in reducing or even reversing the rate of growth of hemangiomas, particularly in patients with flat or segmental hemangiomas. Because of the possible cardiac side effects, this medication should only be given while under the care of a pediatric cardiologist or other birthmark specialist. For early, superficial hemangiomas, a topical form of propranolol (Timolol) may be prescribed.
Steroids were often used in the past to reduce the rate of hemangioma growth, particularly during the first few months of life. With the current use of propranolol, oral steroids are rarely given anymore. However, for large, compound hemangiomas, a steroid injection into the substance of the hemangioma can often result in significant shrinkage and minimize the effects of rapid growth.
Vincristine is a type of chemotherapeutic agent that has also been shown to be effective in treating patients with multiple or large hemangiomas or hemangioendotheliomas. Although rarely used, if indicated, this type of medication requires the placement of a central line for intravenous administration, and should be discussed with a pediatric hematologist oncologist.