Topical timolol for infantile haemangiomas

Background Infantile haemangiomas (IHs) are the most common benign tumour in infancy. All therapeutic options are associated with adverse effects, some of which are serious. Recently, systemic application of propranolol was reported to successfully treat severe haemangioma in infancy. However, oral propranolol can cause severe systemic complications. Objective The aim of the study was to determine the efficacy of topical timolol in IH. Patients and methods Timolol maleate, 0.5%, was applied topically twice daily to the patients with IHs. Two investigators observed the response to treatment by comparing the difference in the size and/or extent and colour of IHs at baseline versus 4, 8 and final visit at 12 weeks. Follow-up of the patients was carried out for 4 weeks after the cessation of treatment to detect any recurrence after improvement. Results Treatment was effective in all patients; 20% showed excellent response (90% clearance), 80% showed partial response (450 to 90%) and none showed minimal (poor) response (o50% improvement). During the follow-up period no recurrence was noticed; yet, two patients continued treatment with further improvement in the lesions. Treatment was well-tolerated without systemic side effects. Only local irritation was noticed in 10% of patients, which did not need cessation of treatment. Conclusion Topical timolol maleate provides a safe and an effective line of treatment in IH.