Systemic Treatment

For larger or more aggressive hemangiomas, treatment usually consists of an oral medication, particularly an oral form of propranolol, to prevent complications.

Oral propranolol:

The use of propranolol – a medication normally used for treating high blood pressure – for hemangiomas was first reported in 2008. Propranolol has been reported to stop hemangiomas from growing and causing actual shrinkage of hemangiomas. Studies are underway to determine the safety and efficacy of this treatment option. Potential side effects include low blood sugar, slowing of the heart rate, and lowering of blood pressure. Patients with asthma should not be treated with this medication.

Read more about propranolol for the treatment of hemangiomas

Right preauricular: This two-month-old boy presented with a large hemangioma of the lateral cheek region. He was treated with oral propranolol, and at 1 year of age (second photo), marked improvement is noted.

Right hemifacial: This child’s hemangioma was treated with systemic prednisolone from 1 to 7 months of age.


Left eyelid and forehead (Segment 1): This child was started on corticosteroids at one month of age and was tapered off by age eight months. At age two years had two pulsed dye laser treatments. A surgery to improve lip contour is planned at age four years.


Left Cheek (Segment 2): This child’s hemangioma was treated with systemic prednisolone from 5 weeks to 10 months of age.