Peer-reviewed veterinary case report
Best treatments for infantile hemangioma in babies under 3 years
By Dong WH et al.·2026·Department of Ultrasound, China·View original on Europe PMC →
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Original publication title: Comparative efficacy of urea, bleomycin, and polidocanol for infantile hemangioma: a retrospective cohort study with ultrasound correlation ultrasound characteristics of infantile hemangioma.
Plain-English summary
This study looked at how effective three different treatments—urea, bleomycin, and polidocanol—are for treating infantile hemangiomas, which are common benign tumors in infants. Researchers analyzed 234 cases of these tumors in infants aged 0 to 3 years who received two treatments spaced four months apart. They found that bleomycin was the most effective, with 40% of cases showing complete improvement after six months, while urea and polidocanol had lower success rates of 33% and 25%, respectively. The study also noted that a decrease in blood flow to the tumor, measured by ultrasound, was linked to better treatment outcomes, but there were no serious side effects reported. Overall, bleomycin appears to be the best option for quick results, while urea may be better for long-term management, and polidocanol should be used carefully.
Abstract
<h4>Objective</h4>To compare the efficacy of urea, bleomycin, and polidocanol in treating infantile hemangiomas (IHs) and evaluate correlations between ultrasound features and treatment outcomes.<h4>Methods</h4>This retrospective cohort study analyzed 234 IHs cases treated with urea (Group A), bleomycin (Group B), or polidocanol (Group C) between January 2020 and January 2025. Infants aged 0-3 years received two sclerotherapy courses spaced 4 months apart. Outcomes were assessed via clinical measurements, ultrasound evaluations (blood flow grade, vascular proliferation), and physician assessments. Safety and adverse events were also monitored.<h4>Results</h4>Bleomycin demonstrated superior efficacy, with a 40% complete response (CR) rate at 6 months and no non-responsive cases. Urea showed gradual improvement over time (33% CR at 6 months), while polidocanol had variable efficacy (25% CR at 6 months). Reduction in ultrasound-measured blood flow grade strongly correlated with better outcomes (<i>p</i> < 0.05), but vascular proliferation changes (mesh-like texture) showed no clear association. No significant adverse events were reported during the study period.<h4>Conclusion</h4>Bleomycin is the most effective and stable sclerotherapy for IHs, particularly for rapid response. Urea may suit long-term management, while polidocanol requires cautious use. The reduction in blood flow grade, as assessed by ultrasound, is a significant predictor of better therapeutic outcomes. These findings suggest that monitoring blood flow grade through ultrasound could serve as a valuable tool for clinicians to evaluate the efficacy of sclerotherapy in real-time. As a retrospective study, these findings should be interpreted with consideration of potential selection bias. Further prospective studies are needed to validate results and optimize protocols. The study design is retrospective, which introduces potential biases such as selection bias and confounding variables. The conclusions drawn from this study should be interpreted with caution due to these limitations. Future research should include prospective, randomized controlled trials to validate the findings and minimize biases.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/41816669