Efficacy and safety of topical  β-blockers (0.5% timolol maleate eye drops) in the treatment of infantile haemangiomas

Background: Therapeutic options for infantile haemangiomas (IH) are limited. Recently, timolol maleate, a topical nonselective beta-blocker, has been reported as a potentially effective treatment for IH.

Objectives: To assess the efficacy and safety of topical blockers (0.5% timolol maleate eye drops) in the treatment of infantile haemangiomas.

Methods: Study was carried out at the Dermatology Unit of the Lady Ridgeway Hospital for Children, Colombo. All Infants referred to the Dermatology Clinic, aged 2 months to 2 and 1/2 years who had uncomplicated haemangiomas of proliferative phase irrespective of the anatomical site were selected after informed written consent. 0.5% timolol maleate eye drops were applied twice a day as the treatment. Two investigators independently analyzed the response to treatment by comparing digital photographs at baseline vs 4 weekly for one year or up to resolution.

Results: 40 subjects were identified. Female preponderance was seen (70%). Cox proportional hazard regression revealed group of patients who were started treating during the 1^st year of life show better outcomes. (treatment median 5 months) (p value 0.002). No side effects were reported.

Conclusions: Topical beta-blocker (timolol 0.5% ophthalmic solution) administration provides a safe and effective alternative for treating infantile haemangiomas. Best time for timolol treatment were the IH is in its early proliferative phase.