A prospective self‐controlled study of topical timolol 0.5% cream for large superficial infantile hemangiomas

Abstract

Timolol has recently been reported to be an effective and safe treatment for small and superficial infantile hemangiomas (IH). However, it is controversial to choose it as an alternative to oral propranolol for large superficial IH. In this study, we generated a new modified timolol agent as the base of an ointment. To evaluate the efficacy and safety of this new agent, we recruited 20 patients with large superficial IH. The average age was 4 months old. The average area of the IH was 28.8 cm(2) . The treatment was continued for 2-6 months. Three assessors were asked to judge the changes in both the treated and untreated parts separately by comparing photographs. After an average of 3.25 months of treatment, the average visual analog scale scores were 5.5 and 4.3 for those with and without the medication, respectively. The treated parts regressed significantly more than the untreated parts (P < 0.05). There were no side-effects observed during treatment. High performance liquid chromatography was used to detect the serum concentration of timolol, and no timolol was detected in any of the blood samples (<0.02 μg/mL). Our new modified timolol agent is proven to be an effective therapy option for IH. Prospective studies with high-precision serum timolol concentrations, with heart rate or blood pressure monitoring during treatment, are needed to evaluate potential systemic absorption when using timolol on large IH.

Psoriasis precipitated by timolol eye drops. A series of eight cases

“…Transcutaneous absorption was evaluated in a prospective study of topical timolol 0.5% cream for large superficial infantile haemangiomas, and no timolol was detected in any of the blood samples (<0.02 μg/mL). Moreover, no side effects were observed during treatment . Indeed, no cases of psoriasis have been related to the cutaneous use of timolol to date.…”

“…Moreover, no side effects were observed during treatment. 12 Indeed, no cases of psoriasis have been related to the cutaneous use of timolol to date. Our series has various limitations including small number of patients as well as the absence of histological confirmation.…”

Prospective, open‐label, rater‐blinded and self‐controlled pilot study of the treatment of proliferating superficial infantile hemangiomas with 0.5% topical timolol cream versus 595‐nm pulsed dye laser

“…4 The parents or guardians were instructed to apply the timolol 0.5% cream onto the surface of the appropriate area four times daily. 4 The parents or guardians were instructed to apply the timolol 0.5% cream onto the surface of the appropriate area four times daily.…”

“…1 Since oral propranolol was serendipitously observed in 2008 to be effective in treating IH, 2 it is now widely used in patients as the first-line therapy. 4 It is particularly useful for superficial types of IH with less systemic absorption or cardiovascular side-effects compared with oral propranolol. 4 It is particularly useful for superficial types of IH with less systemic absorption or cardiovascular side-effects compared with oral propranolol.…”

“…3 Recently, a non-selective topical beta-blocker, timolol maleate 0.5% cream designed by our center, was reported to be an effective and safe treatment for IH. 4 It is particularly useful for superficial types of IH with less systemic absorption or cardiovascular side-effects compared with oral propranolol. 4 The use of pulsed dye laser (PDL) in the treatment of IH is controversial, although it has already been widely used for such purpose.…”