Management of infantile haemangioma

Infantile haemangioma (IH) are benign vascular tumours affecting 4–5% of infants. Natural history is of rapid growth in the first few months of life followed by stabilisation and gradual resolution. IH are usually an isolated cutaneous problem. Occasionally they may be associated with internal haemangioma or other abnormalities of cardiovascular and neurological systems. Treatment is required in the first few months of life for IH which are threatening life or function, become ulcerated, or are likely to cause residual problems due to site or large size. First line treatment in most centres is oral propranolol, despite it being unlicensed for this indication. Treatment is continued until 12–16 months of age; there is a small risk of rebound growth after stopping. Other treatments that may be considered in specific situations include oral or intra-lesional steroids, vincristine, pulsed dye laser, embolisation and surgery. A multi-disciplinary approach involving paediatricians, dermatologists and other organ specialists is required to ensure consistent and optimum management for this common condition.