What medication can be applied to hemangiomas to make them regress?

For hemangiomas, topical medications such as beta-blockers, corticosteroid ointments, imiquimod cream, 5% imiquimod gel, and traditional Chinese medicine (TCM)-based topical formulations may be used under medical guidance to assist in lesion regression. If skin redness, swelling, ulceration occurs after medication use, or if the hemangioma does not shrink, prompt medical consultation is recommended.

1. Beta-blocker ointments: Examples include timolol maleate eye drops (diluted for topical use) and propranolol hydrochloride gel. These work by inhibiting vascular proliferation and inducing vasoconstriction to promote lesion shrinkage. They are suitable for superficial infantile hemangiomas and have a relatively high safety profile.

2. Corticosteroid ointments: For example, hydrocortisone butyrate cream, which is appropriate for mild proliferative superficial hemangiomas. It alleviates symptoms by reducing inflammation and preventing blood vessel dilation. Usage duration should be carefully controlled to avoid prolonged application that could lead to skin atrophy.

3. Imiquimod cream: This activates local immune responses to inhibit angiogenesis and is suitable for superficial hemangiomas in adults or older children. It is typically applied 2–3 times per week. Localized erythema and itching may occur but are generally tolerable.

4. 5% Imiquimod gel: With a mechanism of action similar to the cream, the gel formulation has slightly better skin penetration and is more suitable for hemangiomas on thicker skin areas. Care should be taken to avoid mucosal areas to prevent irritation.

5. Traditional Chinese medicine (TCM)-based topical agents: Such as ointments containing herbal ingredients like Salvia miltiorrhiza (Danshen) and Carthamus tinctorius (Honghua), which help reduce hemangiomas through promoting blood circulation, resolving stasis, and dispersing nodules. These are primarily used as adjunctive therapy and should be combined with Western medicine based on individual conditions.

Topical medications are mostly effective for superficial and small-sized hemangiomas and must be used under physician supervision. Larger, deeper, or lesions located in special areas often respond poorly to topical treatments alone and require additional therapeutic approaches. During daily application, clean the affected skin first and apply a thin layer of medication to avoid overuse. Monitor for skin reactions, keep the lesion area dry, and wear loose clothing to minimize friction.