Prognostic Factors for Long-term Aesthetic Outcome of Infantile Haemangioma Treated with Beta-blockers

Parents of infants treated with beta-blockers for infantile haemangioma are often concerned about the long-term aesthetic outcome. This cross-sectional study assessed the influence on the long-term aesthetic outcome of characteristics of the infantile haemangioma, the beta-blocker treatment, and the infant. The study included 103 children aged 6–12 years, treated with beta-blockers (propranolol or atenolol) for infantile haemangioma during infancy (age at treatment initiation ≤1 year) for ≥6 months. Dermatologists and parents scored the Patient Observer Scar Assessment Scale, and the child scored a visual analogue scale. Dermatologists identified whether telangiectasia, fibrofatty tissue, and atrophic scar tissue were present. The long-term aesthetic outcome of infantile haemangioma was judged more negatively by dermatologists and parents in case of a superficial component, ulceration, older age at treatment initiation, higher cumulative dose, and/or shorter follow-up time. According to children, infantile haemangioma located on the head had better aesthetic outcome than infantile haemangioma located elsewhere. Close monitoring, particularly of infantile haemangioma with a superficial component, is essential for early initiation of treatment, and to prevent or treat ulceration. These outcome data can support parental counselling and guide treatment strategy. SIGNIFICANCE Parents of infants receiving beta-blockers for infantile haemangioma commonly ask their physician about the aesthetics of infantile haemangioma at school age. This study evaluated which characteristics during beta-blocker treatment are associated with long-term (≥6 years) aesthetic outcome. Negative aesthetics were found for children with infantile haemangioma with a superficial component, ulcerated infantile haemangioma, older age at treatment initiation, higher cumulative dose, and shorter follow-up time. As this study considered the perspectives of dermatologists, parents, and children in multivariable analyses, the results readily apply to clinical practice. Using this information, physicians can inform parents and assess whether additional treatment (e.g. surgery or laser treatment) is needed.