Ulceration
Ulceration, which is the most common complication of IH, can cause significant morbidity due to the development of severe pain, bleeding, scarring, and risk of infection. A recent study looked at 33 children with ulcerated IH (76% received previous therapy with no improvement), who were treated with propranolol at doses ranging from 2–3 mg/kg/day. Complete healing was noted at a mean of 5.7 weeks and average time to achieving pain control was 14.5 days. However, 4 infants experienced recurrence of ulceration following cessation of therapy.